超声检测颈动脉和股动脉分叉斑块作为心血管事件的预测因子。

IF 2.4 4区 医学 Q3 PERIPHERAL VASCULAR DISEASE
Aleš Blinc, Andrew N Nicolaides, Pavel Poredoš, Kosmas I Paraskevas, Christian Heiss, Oliver Müller, Christos Rammos, Agata Stanek, Borut Jug
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引用次数: 0

摘要

基于风险因素的算法在人群水平上可以很好地估计心血管(CV)风险,但在个体水平上往往不准确。超声检测颈动脉和股动脉总分支的临床前动脉粥样硬化斑块是一种简单、无创的检测个体动脉粥样硬化的方法,从而更准确地估计他/她未来心血管事件的风险。即使在调整了传统的危险因素后,这些分叉处斑块的存在也与心血管死亡和心肌梗死的风险增加独立相关,而易损斑块的超声特征主要与同侧缺血性卒中的风险增加相关。颈动脉和股动脉斑块对心血管事件的预测价值与斑块负荷成正比,特别是随着时间的推移斑块的进展。通过评估颈动脉和/或股总分叉斑块的负担,可以根据基于风险因素的算法将大量低风险个体重新分类为中度或高度心血管风险,将中度风险个体重新分类为低或高度心血管风险。正在进行的多模态影像学研究,辅以临床和遗传数据,借助机器学习/人工智能分析,有望促进我们对动脉粥样硬化从无症状到症状阶段的进展和个性化预防的理解。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Carotid and femoral bifurcation plaques detected by ultrasound as predictors of cardiovascular events.

Risk factor-based algorithms give a good estimate of cardiovascular (CV) risk at the population level but are often inaccurate at the individual level. Detecting preclinical atherosclerotic plaques in the carotid and common femoral arterial bifurcations by ultrasound is a simple, non-invasive way of detecting atherosclerosis in the individual and thus more accurately estimating his/her risk of future CV events. The presence of plaques in these bifurcations is independently associated with increased risk of CV death and myocardial infarction, even after adjusting for traditional risk factors, while ultrasonographic characteristics of vulnerable plaque are mostly associated with increased risk for ipsilateral ischaemic stroke. The predictive value of carotid and femoral plaques for CV events increases in proportion to plaque burden and especially by plaque progression over time. Assessing the burden of carotid and/or common femoral bifurcation plaques enables reclassification of a significant number of individuals with low risk according risk factor-based algorithms into intermediate or high CV risk and intermediate risk individuals into the low- or high CV risk. Ongoing multimodality imaging studies, supplemented by clinical and genetic data, aided by machine learning/ artificial intelligence analysis are expected to advance our understanding of atherosclerosis progression from the asymptomatic into the symptomatic phase and personalize prevention.

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来源期刊
CiteScore
3.90
自引率
11.10%
发文量
61
审稿时长
1 months
期刊介绍: Vasa is the European journal of vascular medicine. It is the official organ of the German, Swiss, and Slovenian Societies of Angiology. The journal publishes original research articles, case reports and reviews on vascular biology, epidemiology, prevention, diagnosis, medical treatment and interventions for diseases of the arterial circulation, in the field of phlebology and lymphology including the microcirculation, except the cardiac circulation. Vasa combines basic science with clinical medicine making it relevant to all physicians interested in the whole vascular field.
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