title: Young smoker "ABCD" vascular assessment: a four-step ultrasound examination for detecting peripheral, extra and intra-cranial early arterial damage.
abstract: Cigarette smoking is known as a major risk factor in the pathogenic mechanisms of stroke, coronary and peripheral artery disease (CAD and PAD), even in young subjects. The aim of this study is the creation of a four-step ultrasound examination to evaluate and monitor the peripheral, the extra and the intra-cranial assessment of the arterial early damage in smokers. The evaluations of A, the Ankle-brachial index, ABI, B, the Breath holding index, BHI, C, the Carotid intima media thickness, CIMT, and D, the Diameter of the abdominal aorta represent the "ABCD" assessment.
  
  
  
  Thirty-eight healthy smokers and 43 controls underwent A, calculated for each leg. B was calculated after determination of subjects' flow velocity of middle cerebral artery (MCA) by trans-cranial colour Doppler (TCCD) before and after 30 s of apnoea at baseline and just after smoking a cigarette, to simulate the chronic and acute effects of smoking. Finally, C and D evaluation were assessed using a high-resolution B-mode ultrasound.
  
  
  
  Smokers presented higher values of CIMT (mean and maximal), and lower BHI both at baseline and just after smoking (p < 0.01), though in the normal range. No significant differences were found for A and D between smokers and non- smokers.
  
  
  
  Our results underline the importance of the assessment of B and C, that, though in the normal range, present significant differences between smokers and non-smokers. These data could drive the screening between smokers in age-related manner. Moreover, the "ABCD" examination could represent a valid method to detect and then monitor smokers' vascular damage. Although it is far to be considered a screening and routine tool, it should be contemplated in a wider context of possible not-invasive practical screening and follow-up modalities. This would be designed to implement preventive strategies and tools aimed at discouraging tobacco addiction and monitoring cardiovascular risk patients.
authors.affiliation: Department of Medicine, Section of Internal Medicine, University of Verona, Piazzale L.A. Scuro, 10-37134, Verona, Italy. chiaramozzini@libero.it.
authors.forename: Chiara
authors.initials: C
authors.lastname: Mozzini
authors.affiliation: Ultrasound Association of South-Tyrol, Bolzano Health District, Piazza W.A. Loew-Cadonna, 12-39100, Bolzano, Italy.
authors.forename: Alder
authors.initials: A
authors.lastname: Casadei
authors.affiliation: Department of Internal Medicine, Bolzano Central Hospital, via L. Bohler, 5-39100, Bolzano, Italy.
authors.forename: Giuseppe
authors.initials: G
authors.lastname: Roscia
authors.affiliation: Department of Medicine, Section of Internal Medicine, University of Verona, Piazzale L.A. Scuro, 10-37134, Verona, Italy.
authors.forename: Luciano
authors.initials: L
authors.lastname: Cominacini
mesh_terms: D000328:Adult; D055109:Ankle Brachial Index / Q000379:methods*; D001012:Aorta, Abdominal / Q000000981:diagnostic imaging / Q000503:physiopathology; D001783:Blood Flow Velocity / Q000502:physiology*; D001916:Brachial Artery / Q000000981:diagnostic imaging* / Q000503:physiopathology; D002339:Carotid Arteries / Q000000981:diagnostic imaging* / Q000503:physiopathology; D059168:Carotid Intima-Media Thickness; D003324:Coronary Artery Disease / Q000175:diagnosis* / Q000503:physiopathology; D042241:Early Diagnosis; D005260:Female; D064368:Healthy Volunteers; D006801:Humans; D008297:Male; D058729:Peripheral Arterial Disease / Q000175:diagnosis* / Q000503:physiopathology; D012307:Risk Factors; D012907:Smoking / Q000009:adverse effects; D018615:Ultrasonography, Doppler, Color / Q000379:methods; D055815:Young Adult
keywords: Abdominal aorta diameter; Ankle-brachial index; Breath holding index; Carotid intima-media thickness; Early arterial damage; Smoking