An Abbreviated Carotid Intima-Media Thickness Scanning Protocol to Facilitate Clinical Screening for Subclinical Atherosclerosis

• Published in: Journal of the American Society of Echocardiography Vol. 20; no. 11; pp. 1269 - 1275
• Main Authors: Gepner, Adam D., BS, Wyman, Rachael A., MD, Korcarz, Claudia E., DVM, RDCS, FASE, Aeschlimann, Susan E., RDMS, RVT, Stein, James H., MD, FASE
• Format: Journal Article
• Language: English
• Published: United States Mosby, Inc 01-11-2007
• Subjects: Cardiovascular; Carotid Arteries - diagnostic imaging; Carotid Artery Diseases - diagnostic imaging; Echocardiography - methods; Female; Humans; Image Interpretation, Computer-Assisted - methods; Male; Mass Screening - methods; Middle Aged; Prognosis; Reproducibility of Results; Risk Assessment - methods; Risk Factors; Sensitivity and Specificity; Tunica Intima - diagnostic imaging
• ISSN: 0894-7317; 1097-6795
• DOI: 10.1016/j.echo.2007.03.009

Background Carotid intima-media thickness (CIMT) testing can assist with cardiovascular risk prediction; however, the requirement for rigorous, time-consuming protocols has limited it use in clinical practice. Methods Bilateral images of the common carotid artery (CCA), bulb, and internal carotid artery segments were obtained using a comprehensive scanning protocol. Three abbreviated scanning protocols were evaluated for their ability to identify patients with increased CIMT (≥75th percentile). Results Of 261 subjects, 134 (51.3%) had increased left or right CCA CIMT (CCA protocol), 136 (52.1%) had carotid plaque (plaque protocol), and 190 (72.7%) had plaque or at least one increased CCA CIMT (combination protocol). The area under the receiver-operator characteristic curves for the CCA (0.738) and combination protocols (0.692) were higher than the plaque protocol (0.625, P < .05). The combination protocol was 100% sensitive. Conclusions Compared with a comprehensive scanning protocol, plaque screening with measurement of far wall CCA CIMT identifies all patients with increased CIMT.