Intima-Media-Dicke und atherosklerotische Plaques der Arteria carotis

Kardiovaskuläre und zerebrovaskuläre Erkrankungen gehören weltweit zu den häufigsten Todesursachen. Zur frühzeitigen Identifizierung und präventiven Behandlung von asymptomatischen Hochrisikopersonen ist eine verlässliche Vorhersage des individuellen Risikos eine essenzielle Voraussetzung. Der vorliegende CME-Artikel beleuchtet den Stellenwert von Biomarkern subklinischer Atherosklerose für die individuelle Risikoprädiktion.

Abstract

Early identification and preventive treatment of asymptomatic subjects with high risk for cardiovascular and cerebrovascular diseases requires accurate individual risk prediction. This article reviews the role of ultrasonography-based biomarker of subclinical atherosclerosis such as carotid intima-media thickness or atherosclerotic plaques for individual risk assessment. The article summarizes the results of cohort studies which investigated the additive effect of ultrasonography-based biomarkers to well-established risk models based on a combination of traditional risk factors. Furthermore, the article reviews the association of less well-established plaque characteristics like plaque echolucency and intraplaque neovascularization with cardiovascular and cerebrovascular diseases.

Schlüsselwörter

Intima-Media-Dicke - atherosklerotische Plaque - A. carotis - B-Bild-Sonografie - zerebrovaskuläre Erkrankung - kardiovaskuläre Erkrankung - Risikoprädiktion

Key words

intima media thickness - atherosclerotic plaques - carotid artery - B-mode ultrasonography - cerebrovascular disease - cardiovascular disease - risk prediction

Publikationsverlauf

Artikel online veröffentlicht:
31. Mai 2023

• Literatur

• 1 Naqvi TZ, Lee MS. Carotid intima-media thickness and plaque in cardiovascular risk assessment. JACC Cardiovasc Imag 2014; 7: 1025-1038 DOI: 10.1016/j.jcmg.2013.11.014.
• 2 Lorenz MW, Schaefer C, Steinmetz H. et al. Is carotid intima media thickness useful for individual prediction of cardiovascular risk? Ten-year results from the Carotid Atherosclerosis Progression Study (CAPS). Eur Heart J 2010; 31: 2041-2048 DOI: 10.1093/eurheartj/ehq189.
• 3 Den Ruijter HM, Peters SA, Anderson TJ. et al. Common carotid intima-media thickness measurements in cardiovascular risk prediction: a meta-analysis. JAMA 2012; 308: 796-803 DOI: 10.1001/jama.2012.9630.
• 4 Nambi V, Chambless L, Folsom AR. et al. Carotid intima-media thickness and presence or absence of plaque improves prediction of coronary heart disease risk: the ARIC (Atherosclerosis Risk In Communities) study. J Am Coll Cardiol 2010; 55: 1600-1607 DOI: 10.1016/j.jacc.2009.11.075.
• 5 Polak JF, Szklo M, O'Leary DH. Carotid intima-media thickness score, positive coronary artery calcium score, and incident coronary heart disease: the multi-ethnic study of atherosclerosis. J Am Heart Assoc 2017; 6: e004612 DOI: 10.1161/JAHA.116.004612.
• 6 Amato M, Veglia F, de Faire U. et al. Carotid plaque-thickness and common carotid IMT show additive value in cardiovascular risk prediction and reclassification. Atherosclerosis 2017; 263: 412-419 DOI: 10.1016/j.atherosclerosis.2017.05.023.
• 7 Bond MG, Wilmoth SK, Gardin JF. et al. Noninvasive assessment of atherosclerosis in nonhuman primates. Adv Exp Med Biol 1985; 183: 189-195 DOI: 10.1007/978–1-4613–2459–1_15.
• 8 Pignoli P, Tremoli E, Poli A. et al. Intimal plus medial thickness of the arterial wall: a direct measurement with ultrasound imaging. Circulation 1986; 74: 1399-1406 DOI: 10.1161/01.cir.74.6.1399.
• 9 Touboul PJ, Hennerici MG, Meairs S. et al. Mannheim carotid intima-media thickness and plaque consensus (2004–2006–2011). An update on behalf of the advisory board of the 3rd, 4th and 5th watching the risk symposia, at the 13th, 15th and 20th European Stroke Conferences, Mannheim, Germany, 2004, Brussels, Belgium, 2006, and Hamburg, Germany, 2011. Cerebrovasc Dis 2012; 34: 290-296 DOI: 10.1159/000343145.
• 10 Wikstrand J. Methodological considerations of ultrasound measurement of carotid artery intima-media thickness and lumen diameter. Clin Physiol Funct Imaging 2007; 27: 341-345 DOI: 10.1111/j.1475–097X.2007.00757.x.
• 11 Riley WA, Barnes RW, Bond MG. et al. High-resolution B-mode ultrasound reading methods in the Atherosclerosis Risk in Communities (ARIC) cohort. J Neuroimag 1991; 1: 168-172 DOI: 10.1111/jon199114168.
• 12 Ebrahim S, Papacosta O, Whincup P. et al. Carotid plaque, intima media thickness, cardiovascular risk factors, and prevalent cardiovascular disease in men and women: the British Regional Heart Study. Stroke 1999; 30: 841-850 DOI: 10.1161/01.str.30.4.841.
• 13 Liao X, Norata GD, Polak JF. et al. Normative values for carotid intima media thickness and its progression: Are they transferrable outside of their cohort of origin. ? Eur J Prev Cardiol 2016; 23: 1165-1173 DOI: 10.1177/2047487315625543.
• 14 Johri AM, Nambi V, Naqvi TZ. et. al Recommendations for the assessment of carotid arterial plaque by ultrasound for the characterization of atherosclerosis and evaluation of cardiovascular risk: From the American Society of Echocardiography. J Am Soc Echocardiogr 2020; 33: 917-933 DOI: 10.1016/j.echo.2020.04.021.
• 15 Piepoli MF, Hoes AW, Agewall S. et al. 2016 European Guidelines on cardiovascular disease prevention in clinical practice: The Sixth Joint Task Force of the European Society of Cardiology and Other Societies on Cardiovascular Disease Prevention in Clinical Practice (constituted by representatives of 10 societies and by invited experts) Developed with the special contribution of the European Association for Cardiovascular Prevention & Rehabilitation (EACPR). Eur Heart J 2016; 37: 2315-2381 DOI: 10.1093/eurheartj/ehw106.
• 16 Geroulakos G, Ramaswami G, Nicolaides A. et al. Characterization of symptomatic and asymptomatic carotid plaques using high-resolution real-time ultrasonography. Br J Surg 1993; 80: 274-277 DOI: 10.1002/bjs.1800801016.
• 17 Topakian R, King A, Kwon SU. et al. Ultrasonic plaque echolucency and emboli signals predict stroke in asymptomatic carotid stenosis. Neurology 2011; 77: 751-758 DOI: 10.1212/WNL.0b013e31822b00a6.
• 18 Nicolaides AN, Kakkos SK, Kyriacou E. et al. Asymptomatic internal carotid artery stenosis and cerebrovascular risk stratification. J Vasc Surg 2010; 52: 1486-1496 DOI: 10.1016/j.jvs.2010.07.021.
• 19 Kakkos SK, Griffin MB, Nicolaides AN. et al. The size of juxtaluminal hypoechoic area in ultrasound images of asymptomatic carotid plaques predicts the occurrence of stroke. J Vasc Surg 2013; 57: 609-618 DOI: 10.1016/j.jvs.2012.09.045.
• 20 Coli S, Magnoni M, Sangiorgi G. et al. Contrast-enhanced ultrasound imaging of intraplaque neovascularization in carotid arteries: correlation with histology and plaque echogenicity. J Am Coll Cardiol 2008; 52: 223-230 DOI: 10.1016/j.jacc.2008.02.082.
• 21 Cui L, Xing Y, Wang L. et al. Carotid Intraplaque Neovascularization and Future Vascular Events in Patients With Asymptomatic Carotid Stenosis. Front Pharmacol 2022; 13: 804810 DOI: 10.3389/fphar.2022.804810.
• 22 Näslund U, Ng N, Lundgren A. et al. Visualization of asymptomatic atherosclerotic disease for optimum cardiovascular prevention (VIPVIZA): a pragmatic, open-label, randomised controlled trial. Lancet 2019; 393: 133-142 DOI: 10.1016/S0140-6736(18)32818-6.