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Atherosclerosis in abdominal aortic aneurysms: a causal event or a process running in parallel? The Tromsø study.

https://arctichealth.org/en/permalink/ahliterature97485
Source
Arterioscler Thromb Vasc Biol. 2010 Jun;30(6):1263-8
Publication Type
Article
Date
Jun-2010
Author
Stein Harald Johnsen
Signe Helene Forsdahl
Kulbir Singh
Bjarne Koster Jacobsen
Author Affiliation
Department of Neurology, University Hospital North Norway, N-9038 Tromsø, Norway. sh_johnsen@live.no
Source
Arterioscler Thromb Vasc Biol. 2010 Jun;30(6):1263-8
Date
Jun-2010
Language
English
Geographic Location
Norway
Publication Type
Article
Keywords
Adult
Age Factors
Aged
Aortic Aneurysm, Abdominal - epidemiology - ultrasonography
Atherosclerosis - epidemiology - ultrasonography
Carotid Artery Diseases - epidemiology
Comorbidity
Coronary Artery Disease - epidemiology - ultrasonography
Female
Femoral Artery - ultrasonography
Humans
Linear Models
Logistic Models
Male
Middle Aged
Norway - epidemiology
Odds Ratio
Peripheral Vascular Diseases - epidemiology - ultrasonography
Population Surveillance
Prevalence
Prospective Studies
Risk assessment
Risk factors
Sex Factors
Abstract
OBJECTIVE: The pathogenesis of abdominal aortic aneurysm (AAA) formation is poorly understood. We investigated the relationship between carotid, femoral, and coronary atherosclerosis and abdominal aortic diameter, and whether atherosclerosis was a risk marker for AAA. METHODS AND RESULTS: Ultrasound of the right carotid artery, the common femoral artery, and the abdominal aorta was performed in 6446 men and women from a general population. The burden of atherosclerosis was assessed as carotid total plaque area, common femoral lumen diameter, and self-reported coronary heart disease. An AAA was defined as maximal infrarenal aortic diameter > or =30 mm. No dose-response relationship was found between carotid atherosclerosis and abdominal aortic diameter or =27 mm and in AAAs. The age- and sex-adjusted odds ratio (OR) (95% CI) for AAA in the top total plaque area quintile was 2.3 (1.5 to 3.4), as compared with subjects without plaques. The adjusted OR (95% CI) was 1.7 (1.1 to 2.6). No independent association was found between femoral lumen diameter and AAA. CONCLUSIONS: The lack of a consistent dose-response relationship between atherosclerosis and abdominal aortic diameter suggests that atherosclerosis may not be a causal event in AAA but develops in parallel with or secondary to aneurismal dilatation.
Notes
RefSource: Arterioscler Thromb Vasc Biol. 2010 Jun;30(6):1075-7
PubMed ID
20360536 View in PubMed
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Marked variations in serial coronary artery diameter measures in Kawasaki disease: a new indicator of coronary involvement.

https://arctichealth.org/en/permalink/ahliterature122372
Source
J Am Soc Echocardiogr. 2012 Aug;25(8):859-65
Publication Type
Article
Date
Aug-2012
Author
Frédéric Dallaire
Anne Fournier
Jolène Breton
Thanh-Diem Nguyen
Linda Spigelblatt
Nagib Dahdah
Author Affiliation
Division of Pediatric Cardiology, Department of Pediatrics, Laval University Hospital, Faculty of Medicine, Laval University, Quebec, Quebec, Canada.
Source
J Am Soc Echocardiogr. 2012 Aug;25(8):859-65
Date
Aug-2012
Language
English
Publication Type
Article
Keywords
Child, Preschool
Comorbidity
Coronary Artery Disease - epidemiology - ultrasonography
Coronary Vessels - ultrasonography
Echocardiography - statistics & numerical data
Female
Humans
Infant
Male
Mucocutaneous Lymph Node Syndrome - epidemiology - ultrasonography
Prevalence
Quebec - epidemiology
Reproducibility of Results
Risk factors
Sensitivity and specificity
Abstract
The long-term risk of patients with Kawasaki disease is not well defined. A great proportion of patients with Kawasaki disease have important variation of their coronary artery (CA) diameters, but the significance of this variation is not known. The aim of this study was to test the hypothesis that patients within the normal range of CA diameters but with important Z-score variation have a stronger inflammatory response and increased resistance to treatment than those without such Z-score variation.
A retrospective study was conducted in 197 patients with Kawasaki disease with serial echocardiograms up to 12 months after diagnosis. Patients with occult CA dilatation (variation > 2 Z-score units but within the normal range) were compared with patients with definite CA dilatation (Z score > 2.5) and with patients with normal CA for resistance to treatment and systemic inflammatory parameters.
A total of 63 patients (32.0%) were identified with Z scores always within the normal range but with important variation of CA diameter during follow-up (occult dilatation). There was a strong statistically significant trend of increasing inflammatory marker levels across patient categories (normal > occult dilatation > definite dilatation). Furthermore, resistance to intravenous immunoglobulin therapy was significantly increased in patients with occult dilatation compared with patients with normal CAs (relative risk, 2.6; 95% confidence interval, 1.21-5.44; P = .006).
The suggested definition of occult CA dilatation identified patients with CA involvement currently unrecognized per the current guidelines. These patients might be at a higher CA risk than previously thought.
PubMed ID
22824173 View in PubMed
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Migration at early age from a high to a lower coronary heart disease risk country lowers the risk of subclinical atherosclerosis in middle-aged men.

https://arctichealth.org/en/permalink/ahliterature90079
Source
J Intern Med. 2009 Mar;265(3):345-58
Publication Type
Article
Date
Mar-2009
Author
Jartti L.
Rönnemaa T.
Raitakari O T
Hedlund E.
Hammar N.
Lassila R.
Marniemi J.
Koskenvuo M.
Kaprio J.
Author Affiliation
Department of Geriatric Medicine, University of Turku, Turku, Finland.
Source
J Intern Med. 2009 Mar;265(3):345-58
Date
Mar-2009
Language
English
Publication Type
Article
Keywords
Age Factors
Biological Markers - blood
Carotid Arteries - ultrasonography
Coronary Artery Disease - epidemiology - ultrasonography
Emigration and Immigration
Endothelium, Vascular - physiology
Finland - epidemiology
Humans
Male
Middle Aged
Risk
Socioeconomic Factors
Sweden - epidemiology
Time Factors
Tunica Intima - ultrasonography
Tunica Media - ultrasonography
Twins
Abstract
BACKGROUND: Study of migrants offers a natural model to assess environmental risk of coronary heart disease (CHD) in countries differing in CHD occurrence. In Sweden, CHD risk has been markedly lower than in Finland from where a large migration occurred in the 1970s. OBJECTIVES: To study the structural and functional markers of subclinical atherosclerosis in twin pairs discordant for migration with the main focus on age at migration, length of residence and integration into Swedish society after migration from a high to a lower CHD risk country. METHODS: Carotid intima-media thickness (IMT) and brachial artery endothelial function (EF) were assessed with high-resolution ultrasound and a set of cardiovascular, socio-economic and psychosocial risk factors were estimated in 76 middle-aged male twin pairs discordant for migration from Finland to Sweden. RESULTS: Men who had migrated in adolescence had lower IMT values compared with their co-twins living in Finland (0.665 +/- 0.114 vs. 0.802 +/- 0.167 mm, P = 0.009). Also men who integrated well to Swedish society had lower (0.720 +/- 0.154 vs. 0.799 +/- 0.207 mm, P = 0.013) IMT values than their twin brothers living in Finland. Associations between IMT and migration age and between IMT and integration remained significant in multivariate analyses of several CHD risk factors. The intrapair difference in IMT was significantly associated with immigration age and integration (ANOVA, P = 0.0082), the difference being greatest among pairs where the brother living in Sweden had migrated at early age and integrated well to Swedish society. EF was better in men who had migrated to Sweden before the age of 21 years, but not later, compared with their co-twins in Finland (6.4 +/- 4.6% vs. 3.8 +/- 3.6%, P = 0.025). CONCLUSIONS: Migration at an early age and good integration are beneficial to vascular health associated with moving from a high to a lower CHD risk country, suggesting that an environment-sensitive period influences atherogenesis before adulthood.
PubMed ID
19207372 View in PubMed
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Relationship of the metabolic syndrome to carotid ultrasound traits.

https://arctichealth.org/en/permalink/ahliterature168384
Source
Cardiovasc Ultrasound. 2006;4:28
Publication Type
Article
Date
2006
Author
Rebecca L Pollex
Khalid Z Al-Shali
Andrew A House
J David Spence
Aaron Fenster
Mary Mamakeesick
Bernard Zinman
Stewart B Harris
Anthony J G Hanley
Robert A Hegele
Author Affiliation
Robarts Research Institute, London, Ontario, Canada. rpollex@robarts.ca
Source
Cardiovasc Ultrasound. 2006;4:28
Date
2006
Language
English
Publication Type
Article
Keywords
Adult
Canada - epidemiology
Comorbidity
Coronary Artery Disease - epidemiology - ultrasonography
Female
Humans
Incidence
Male
Metabolic Syndrome X - epidemiology - ultrasonography
Prognosis
Risk Assessment - methods
Risk factors
Sensitivity and specificity
Tunica Intima - ultrasonography
Abstract
The metabolic syndrome is associated with increased vascular disease risk. We evaluated two carotid ultrasound measurements, namely intima media thickness and total plaque volume, in a Canadian Oji-Cree population with a high metabolic syndrome prevalence rate.
As part of the Sandy Lake Complications Prevalence and Risk Factor Study, 166 Oji-Cree subjects (baseline metabolic syndrome prevalence, 44.0%, according to the National Cholesterol Education Program Adult Treatment Panel III guidelines) were examined using a high-resolution duplex ultrasound scanner.
Image analysis showed that mean intima media thickness was elevated in subjects with the metabolic syndrome (818 +/- 18 vs 746 +/- 20 microm), as was total plaque volume (125 +/- 26 vs 77.3 +/- 17.0 mm3). However, after adjustment for age and sex, the differences were significant only for intima media thickness (P = 0.039). Furthermore, a significant trend towards increased intima media thickness was observed with increasing numbers of metabolic syndrome components: mean intima media thickness was highest among individuals with all five metabolic syndrome components compared to those with none (866 +/- 55 vs 619 +/- 23 microm, P = 0.0014). A similar, but non-significant trend was observed for total plaque volume.
This is the first study of the relationship between the metabolic syndrome and two distinct carotid ultrasound traits measured in the same individuals. The results suggest that standard intima media thickness measurement shows a more consistent and stronger association with the metabolic syndrome than does total plaque volume.
Notes
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PubMed ID
16827932 View in PubMed
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