Journal Article

Common Carotid Intima Media Thickness and Ankle-Brachial Pressure Index Correlate with Local but Not Global Atheroma Burden: A Cross Sectional Study Using Whole Body Magnetic Resonance Angiography

Gardner, Michael, Belch, Jill J. F., Weir-McCall, Jonathan R., Rauchhaus, Petra, Adamson, Carly L., Struthers, Allan D., Gandy, Stephen J., Morris, Andrew D., Khan, Faisel, Ramkumar, Prasad Guntur, Houston, J. Graeme, Lambert, Matthew A.

2014

Overview

Common carotid intima media thickness (CIMT) and ankle brachial pressure index (ABPI) are used as surrogate marker of atherosclerosis, and have been shown to correlate with arterial stiffness, however their correlation with global atherosclerotic burden has not been previously assessed. We compare CIMT and ABPI with atheroma burden as measured by whole body magnetic resonance angiography (WB-MRA). 50 patients with symptomatic peripheral arterial disease were recruited. CIMT was measured using ultrasound while rest and exercise ABPI were performed. WB-MRA was performed in a 1.5T MRI scanner using 4 volume acquisitions with a divided dose of intravenous gadolinium gadoterate meglumine (Dotarem, Guerbet, FR). The WB-MRA data was divided into 31 anatomical arterial segments with each scored according to degree of luminal narrowing: 0 = normal, 1 = <50%, 2 = 50-70%, 3 = 70-99%, 4 = vessel occlusion. The segment scores were summed and from this a standardized atheroma score was calculated. The atherosclerotic burden was high with a standardised atheroma score of 39.5±11. Common CIMT showed a positive correlation with the whole body atheroma score (β 0.32, p = 0.045), however this was due to its strong correlation with the neck and thoracic segments (β 0.42 p = 0.01) with no correlation with the rest of the body. ABPI correlated with the whole body atheroma score (β -0.39, p = 0.012), which was due to a strong correlation with the ilio-femoral vessels with no correlation with the thoracic or neck vessels. On multiple linear regression, no correlation between CIMT and global atheroma burden was present (β 0.13 p = 0.45), while the correlation between ABPI and atheroma burden persisted (β -0.45 p = 0.005). ABPI but not CIMT correlates with global atheroma burden as measured by whole body contrast enhanced magnetic resonance angiography in a population with symptomatic peripheral arterial disease. However this is primarily due to a strong correlation with ilio-femoral atheroma burden.

• Publisher: Public Library of Science,Public Library of Science (PLoS)
• Subject: Aged / Angiography / Ankle / Ankle Brachial Index / Arteriosclerosis / Atherosclerosis / Atherosclerotic plaque / Biology and Life Sciences / Biomarkers / Blood vessels / Cardiovascular disease / Carotid Artery, Common - ultrastructure / Carotid Intima-Media Thickness / Contrast Media / Coronary vessels / Correlation / Cross-Sectional Studies / Diabetes / Exercise Test / Female / Femur / Gadolinium / Hospitals / Humans / Intravenous administration / Magnetic resonance / Magnetic Resonance Angiography - methods / Magnetic resonance imaging / Male / Medical imaging / Medical research / Medicine / Medicine and Health Sciences / Meglumine / Middle Aged / Occlusion / Older people / Organometallic Compounds / Peripheral Arterial Disease - pathology / Plaque, Atherosclerotic - pathology / Pressure / Rare earth metal compounds / Resonance / Segments / Single-Blind Method / Statins / Stiffness / Studies / Systematic review / Thorax / Ultrasound / Vascular Stiffness / Whole Body Imaging - methods