From the Laboratory of Clinical Investigation (Y.M., J.M.) and Laboratory
of Cardiovascular Science (E.G.L., J.L.F.), Gerontology Research Center,
National Institute on Aging, National Institutes of Health, Baltimore, Md;
Department of Neurology, Johns Hopkins Bayview Medical Center (C.J.E.,
M.K.K.); and Division of Cardiology, Johns Hopkins University School of
Medicine (L.C.B.), Baltimore, Md.
Correspondence to E. Jeffrey Metter, MD, Laboratory of Clinical Investigation, Gerontology Research Center-Box 06, 5600 Nathan Shock Dr, Baltimore, MD 21224. E-mail jeffrey{at}vax.grc.nia.nih.gov
Background—Previous studies have
shown an association between symptomatic coronary
artery disease (CAD) and increased intimal-medial thickness of the
common carotid artery (CCA IMT), a purported index of
atherosclerosis. This study determines whether CCA IMT
is increased in asymptomatic older subjects with an
ischemic ST-segment response to treadmill exercise.
Methods and Results—CCA IMT was measured by B-mode ultrasound in
community-dwelling volunteers from the Baltimore Longitudinal Study of
Aging, including 397 healthy subjects (age, 58.5±15.8 years) with
normal ECG responses to maximum treadmill exercise, 72
asymptomatic subjects (age, 66.1±13.4 years) with
exercise-induced horizontal or downsloping ST-segment depression
Conclusions—CCA IMT is increased in older subjects with
asymptomatic myocardial ischemia as evidenced by
exercise ECG alone or in combination with thallium scan. Carotid
ultrasound may help to identify asymptomatic individuals
with CAD.
© 1998 American Heart Association, Inc.
Clinical Investigation and Reports
Increased Carotid Artery Intimal-Medial Thickness in Asymptomatic Older Subjects With Exercise-Induced Myocardial Ischemia
1 mm, and 38 subjects (age, 77.4±7.8 years) with clinically
manifest CAD as diagnosed by medical history and resting ECG.
Forty-three subjects with abnormal exercise ECGs also underwent
exercise thallium scintigraphy. Exercise-induced ST-segment
depression was associated with increased IMT (P<0.0001)
independent of age and manifest CAD. After adjustment for age, IMT
values progressively increased from healthy subjects to
asymptomatic subjects with positive exercise ECG alone to
those with concordant positive ECG and thallium scintigraphic findings
who had virtually identical IMT to subjects with manifest CAD. Each
0.1-mm increase in IMT was associated with a 1.91-fold (95% CI, 1.46
to 2.50; P<0.0001) increased risk for concordant
positive exercise tests or manifest CAD, independent of other
significant predictors of CAD.
Key Words: coronary disease • carotid arteries • ultrasonics • exercise • risk factors
This article has been cited by other articles:
 |
|
 |
|
  M. Brzezinski, T. Luisetti, and M. J. London Radial Artery Cannulation: A Comprehensive Review of Recent Anatomic and Physiologic Investigations Anesth. Analg., December 1, 2009; 109(6): 1763 - 1781. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 J. Hashimoto and S. Ito Some mechanical aspects of arterial aging: physiological overview based on pulse wave analysis Therapeutic Advances in Cardiovascular Disease, October 1, 2009; 3(5): 367 - 378. [Abstract] [PDF]
|
|
|
|
 |
|
 C. R. Wendell, A. B. Zonderman, E. J. Metter, S. S. Najjar, and S. R. Waldstein Carotid Intimal Medial Thickness Predicts Cognitive Decline Among Adults Without Clinical Vascular Disease Stroke, October 1, 2009; 40(10): 3180 - 3185. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 Z. Fu, M. Wang, M. Gucek, J. Zhang, J. Wu, L. Jiang, R. E. Monticone, B. Khazan, R. Telljohann, J. Mattison, et al. Milk Fat Globule Protein Epidermal Growth Factor-8: A Pivotal Relay Element Within the Angiotensin II and Monocyte Chemoattractant Protein-1 Signaling Cascade Mediating Vascular Smooth Muscle Cells Invasion Circ. Res., June 19, 2009; 104(12): 1337 - 1346. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 J. H Stein Carotid ultrasound in children: a window to arterial ageing Heart, April 1, 2009; 95(8): 611 - 612. [Full Text] [PDF]
|
|
|
|
 |
|
 P. Kaul and P. S. Douglas Atherosclerosis Imaging: Prognostically Useful or Merely More of What We Know? Circ Cardiovasc Imaging, March 1, 2009; 2(2): 150 - 160. [Full Text] [PDF]
|
|
|
|
 |
|
 S. C. Rice, A. B. Zonderman, E. J. Metter, S. S. Najjar, and S. R. Waldstein Absence of Relation Between Depressive Symptoms and Carotid Intimal Medial Thickness in the Baltimore Longitudinal Study of Aging Psychosom Med, January 1, 2009; 71(1): 70 - 76. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 M. F. O'Rourke Arterial aging: pathophysiological principles Vascular Medicine, November 1, 2007; 12(4): 329 - 341. [Abstract] [PDF]
|
|
|
|
 |
|
 M. Amato, P. Montorsi, A. Ravani, E. Oldani, S. Galli, P. M. Ravagnani, E. Tremoli, and D. Baldassarre Carotid intima-media thickness by B-mode ultrasound as surrogate of coronary atherosclerosis: correlation with quantitative coronary angiography and coronary intravascular ultrasound findings Eur. Heart J., September 1, 2007; 28(17): 2094 - 2101. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 H. Qiu, C. Depre, K. Ghosh, R. G. Resuello, F. F. Natividad, F. Rossi, A. Peppas, Y.-T. Shen, D. E. Vatner, and S. F. Vatner Mechanism of Gender-Specific Differences in Aortic Stiffness With Aging in Nonhuman Primates Circulation, August 7, 2007; 116(6): 669 - 676. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 M. F. O'Rourke and J. Hashimoto Mechanical Factors in Arterial Aging: A Clinical Perspective J. Am. Coll. Cardiol., July 3, 2007; 50(1): 1 - 13. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 M. Wang, J. Zhang, L.-Q. Jiang, G. Spinetti, G. Pintus, R. Monticone, F. D. Kolodgie, R. Virmani, and E. G. Lakatta Proinflammatory Profile Within the Grossly Normal Aged Human Aortic Wall Hypertension, July 1, 2007; 50(1): 219 - 227. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
I. J. Kullo and A. R. Malik Arterial Ultrasonography and Tonometry as Adjuncts to Cardiovascular Risk Stratification J. Am. Coll. Cardiol., April 3, 2007; 49(13): 1413 - 1426. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
J. M. Dijk, Y. van der Graaf, M. L. Bots, D. E. Grobbee, A. Algra, and on behalf of the SMART study group Carotid intima-media thickness and the risk of new vascular events in patients with manifest atherosclerotic disease: the SMART study Eur. Heart J., August 2, 2006; 27(16): 1971 - 1978. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
V. R.S. Fernandes, J. F. Polak, T. Edvardsen, B. Carvalho, A. Gomes, D. A. Bluemke, K. Nasir, D. H. O'Leary, and J. A.C. Lima Subclinical Atherosclerosis and Incipient Regional Myocardial Dysfunction in Asymptomatic Individuals: The Multi-Ethnic Study of Atherosclerosis (MESA) J. Am. Coll. Cardiol., June 20, 2006; 47(12): 2420 - 2428. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
S. S. Najjar, A. Scuteri, and E. G. Lakatta Arterial Aging: Is It an Immutable Cardiovascular Risk Factor? Hypertension, September 1, 2005; 46(3): 454 - 462. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 S. J. Zieman, V. Melenovsky, and D. A. Kass Mechanisms, Pathophysiology, and Therapy of Arterial Stiffness Arterioscler Thromb Vasc Biol, May 1, 2005; 25(5): 932 - 943. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 R. K. Dubey, B. Imthurn, M. Barton, and E. K. Jackson Vascular consequences of menopause and hormone therapy: Importance of timing of treatment and type of estrogen Cardiovasc Res, May 1, 2005; 66(2): 295 - 306. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
A Kablak-Ziembicka, W Tracz, T Przewlocki, P Pieniazek, A Sokolowski, and M Konieczynska Association of increased carotid intima-media thickness with the extent of coronary artery disease Heart, November 1, 2004; 90(11): 1286 - 1290. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
J. F Viles-Gonzalez, V. Fuster, and J. J Badimon Atherothrombosis: A widespread disease with unpredictable and life-threatening consequences Eur. Heart J., July 2, 2004; 25(14): 1197 - 1207. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
G. B. J. Mancini, B. Dahlof, and J. Diez Surrogate Markers for Cardiovascular Disease: Structural Markers Circulation, June 29, 2004; 109(25_suppl_1): IV-22 - IV-30. [Full Text] [PDF]
|
|
|
|
 |
|
 S. Hallerstam, P. T. Larsson, E. Zuber, and S. Rosfors Carotid Atherosclerosis is Correlated with Extent and Severity of Coronary Artery Disease Evaluated by Myocardial Perfusion Scintigraphy Angiology, May 1, 2004; 55(3): 281 - 288. [Abstract] [PDF]
|
|
|
|
|
|
A. Scuteri, S. S. Najjar, D. C. Muller, R. Andres, H. Hougaku, E. J. Metter, and E. G. Lakatta Metabolic syndrome amplifies the age-associated increases in vascular thickness and stiffness J. Am. Coll. Cardiol., April 21, 2004; 43(8): 1388 - 1395. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
A. Scuteri, T. A. Manolio, E. K. Marino, A. M. Arnold, and E. G. Lakatta Prevalence of specific variant carotid geometric patterns and incidence of cardiovascular events in older persons: The cardiovascular health study (CHS E-131) J. Am. Coll. Cardiol., January 21, 2004; 43(2): 187 - 193. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
S. Alan, M. S. Ulgen, O. Ozturk, B. Alan, L. Ozdemir, and N. Toprak Relation Between Coronary Artery Disease, Risk Factors and Intima-Media Thickness of Carotid Artery, Arterial Distensibility, and Stiffness Index Angiology, May 1, 2003; 54(3): 261 - 267. [Abstract] [PDF]
|
|
|
|
|
|
Z. A. Fayad and V. Fuster Clinical Imaging of the High-Risk or Vulnerable Atherosclerotic Plaque Circ. Res., August 17, 2001; 89(4): 305 - 316. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
C. R. Sirtori, L. Calabresi, G. Franceschini, D. Baldassarre, M. Amato, J. Johansson, M. Salvetti, C. Monteduro, R. Zulli, M. L. Muiesan, et al. Cardiovascular Status of Carriers of the Apolipoprotein A-IMilano Mutant : The Limone sul Garda Study Circulation, April 17, 2001; 103(15): 1949 - 1954. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
W. F. Terpstra, J. F. May, A. J. Smit, P. A. de Graeff, F. H. Schuurman, B. M.-d. Jong, and H. J. G. M. Crijns Silent ST Depression and Cardiovascular End-Organ Damage in Newly Found, Older Hypertensives Hypertension, April 1, 2001; 37(4): 1083 - 1088. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
P. M. Okin, M. J. Roman, and R. B. Devereux Exercise-Induced Ischemia and Carotid Atherosclerosis Circulation, December 14, 1999; 100 (24): e119 - e119. [Full Text] [PDF]
|
|
|
|
|
|
Y. Nagai, E J. Metter, and J. L Fleg Increased carotid artery intimal-medial thickness: risk factor for exercise-induced myocardial ischemia in asymptomatic older individuals Vascular Medicine, August 1, 1999; 4(3): 181 - 186. [Abstract] [PDF]
|
|
|
|
|
|
A. Festa, R. D'Agostino Jr, P. Rautaharju, D. H. O'Leary, M. Rewers, L. Mykkanen, and S. M. Haffner Is QT Interval a Marker of Subclinical Atherosclerosis in Nondiabetic Subjects? : The Insulin Resistance Atherosclerosis Study (IRAS) Stroke, August 1, 1999; 30(8): 1566 - 1571. [Abstract] [Full Text] [PDF]
|
|