Assessment of atherosclerosis: should coronary calcium score and intima-media thickness be replaced by ultrasound measurement of carotid plaque burden and vessel wall volume?

IF 3.8 3区 医学 Q2 BIOCHEMISTRY & MOLECULAR BIOLOGY
J David Spence
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引用次数: 2

Abstract

Purpose of review: To describe the uses of vessel wall volume (VWV) and measurement of carotid plaque burden, as total plaque area (TPA) and total plaque volume (TPV), and to contrast them with measurement of carotid intima-media thickness (IMT) and coronary calcium (CAC).

Recent findings: Measurement of carotid plaque burden (CPB) is useful for risk stratification, research into the genetics and biology of atherosclerosis, for measuring effects of new therapies for atherosclerosis, and for treatment of high-risk patients with severe atherosclerosis. It is as predictive of risk as CAC, with important advantages. IMT is only a weak predictor of risk and changes so little over time that it is not useful for assessing effects of therapy.

Summary: Measurement of CPB and VWV are far superior to measurement of carotid IMT in many ways, and should replace it. Vessel wall volume can be measured in persons with no plaque as an alternative to IMT. There are important advantages of CPB over coronary calcium; CPB should be more widely used in vascular prevention.

动脉粥样硬化的评估:是否应该用超声测量颈动脉斑块负荷和血管壁体积来取代冠状动脉钙评分和内膜-中膜厚度?
回顾目的:描述血管壁体积(VWV)和颈动脉斑块负荷测量的用途,如总斑块面积(TPA)和总斑块体积(TPV),并将其与颈动脉内膜-中膜厚度(IMT)和冠状动脉钙(CAC)的测量进行对比。最近的研究发现:颈动脉斑块负荷(CPB)的测量可用于动脉粥样硬化的风险分层、遗传学和生物学研究、动脉粥样硬化新疗法的效果测量以及严重动脉粥样硬化高危患者的治疗。它可以像CAC一样预测风险,具有重要的优势。IMT只是一个较弱的风险预测指标,而且随着时间的推移变化很小,因此它对评估治疗效果没有用处。总结:CPB和VWV的测量在许多方面远远优于颈动脉IMT的测量,应该取代它。没有斑块的人可以测量血管壁体积,作为IMT的替代方法。CPB与冠状动脉钙化相比有重要的优势;CPB应在血管预防中得到更广泛的应用。
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来源期刊
Current opinion in lipidology
Current opinion in lipidology 医学-内分泌学与代谢
CiteScore
6.70
自引率
4.50%
发文量
64
审稿时长
6-12 weeks
期刊介绍: With its easy-to-digest reviews on important advances in world literature, Current Opinion in Lipidology offers expert evaluation on a wide range of topics from six key disciplines including nutrition and metabolism, genetics and molecular biology, and hyperlipidaemia and cardiovascular disease. Published bimonthly, each issue covers in detail the most pertinent advances in these fields from the previous year. This is supplemented by a section of Bimonthly Updates, which deliver an insight into new developments at the cutting edge of the disciplines covered in the journal.
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