title: Carotid artery intima-media thickness is closely related to impaired left ventricular function in patients with coronary artery disease: a single-centre, blinded, non-randomized study.
abstract: BACKGROUND
  Atherosclerosis is the underlying cause of the majority of myocardial infarctions and ischemic strokes. Carotid intima-media thickness (IMT) is a surrogate measure of atherosclerotic cardiovascular disease. Left ventricular (LV) function can be accurately assessed by 2D speckle-tracking strain echocardiography (2D-STE). The aim of this study was to assess the relationship between carotid IMT and LV dysfunction assessed by strain echocardiography in patients with coronary artery disease (CAD).
  
  
  METHODS
  Thirty-one patients with symptoms of CAD were examined with coronary angiography, cardiac echocardiography and carotid ultrasound. Layer-specific longitudinal strains were assessed from endo-, mid- and epicardium by 2D-STE. LV global longitudinal strain (LVGLS) was averaged from 16 longitudinal LV segments in all 3 layers. LVGLS results were compared with coronary angiography findings in a receiver operating curve (ROC) to determine the cut-off for normal and pathological strain values. The calculated optimal strain value was compared to maximal carotid IMT measurements.
  
  
  RESULTS
  The ROC analysis for strain versus coronary angiography was: area under curve (AUC)=0.91 (95% CI 0.80 - 1.0), cut-off value for endocardial LVGLS: -16.7%. Further analyses showed that increased carotid IMT correlated with low absolute strain values (p=0.006) also when adjusted for hypertension, smoking, hyperlipidemia, diabetes and BMI (p=0.02).
  
  
  CONCLUSIONS
  In this study increased carotid IMT values were associated with decreased LV function assessed by strain measurements. These findings support the use of carotid IMT measurements to predict the risk of coronary heart disease.
authors.forename: Kristin
authors.initials: K
authors.lastname: Evensen
authors.forename: Sebastian Imre
authors.initials: SI
authors.lastname: Sarvari
authors.forename: Ole Morten
authors.initials: OM
authors.lastname: Rønning
authors.forename: Thor
authors.initials: T
authors.lastname: Edvardsen
authors.affiliation: Department of Neurology, Oslo University Hospital, Rikshopitalet, Postboks 4950 Nydalen, 0424, Oslo, Norway. david.russell@medisin.uio.no.
authors.forename: David
authors.initials: D
authors.lastname: Russell
mesh_terms: D000368:Aged; D059168:Carotid Intima-Media Thickness; D003324:Coronary Artery Disease / Q000150:complications* / Q000000981:diagnostic imaging*; D004452:Echocardiography / Q000379:methods*; D054459:Elasticity Imaging Techniques / Q000379:methods*; D005260:Female; D006801:Humans; D007090:Image Interpretation, Computer-Assisted / Q000379:methods; D008297:Male; D008875:Middle Aged; D011379:Prognosis; D015203:Reproducibility of Results; D018570:Risk Assessment; D012680:Sensitivity and Specificity; D018487:Ventricular Dysfunction, Left / Q000000981:diagnostic imaging* / Q000209:etiology*