Using Ultrasonography to Test for Future Cardiovascular Disease

According to a team of researchers Johann Wolfgang Goethe-University in Frankfurt, Germany changes in the thickness of the interior walls of the carotid artery is a reliable predictor of future cardiovascular events such as heart attack and/or stroke.

The team conducted a meta-review and analysis of previous studies regarding the use of ultrasound to evaluate thickening of the intima and media layers of the carotid arteries (carotid IMT). At the conclusion of their retrospective analysis (8 different studies with a total of 37,197 subjects who were followed up for a mean of 5.5 years) their results showed that after adjustment for age and sex, increased carotid IMT was associated with increased risk of both MI (myocardial infarction, aka "heart attack") and stroke.

After establishing a "baseline" value among patients without symptoms or a history of cardiovascular disease, the researchers found that:·

The overall risk for cardiovascular disease among those with thickened arterial walls increased from 1.0 to ~1.20, indicating a 20% higher incidence of risk for heart disease· Using the same criteria, overall risk for stroke increased to ~1.30 for a 30% higher risk.

As the authors note, there are several factors in favor of using ultrasonography as both a component of a routine screening exam and as a predictor of future cardiovascular events regarding patients that are already symptomatic:

Ultrasound does not expose the patient to any form of radiation·
The clinical utility of ultrasound as an imaging tool in other areas of medical practice is well-established
The testing guidelines are simple to understand and implement

While admitting that more study will be required, particularly regarding the utility of the exam in determining risk for other cardiovascular conditions, the authors feel that ultrasonography will soon be incorporated into the standard testing regimen when cardiovascular disease is suspected.