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Diagnostic value of carotid intima-media thickness and plaque score for predicting target organ damage in patients with essential hypertension.
Journal of Human Hypertension ( IF 2.7 ) Pub Date : 2004-01-01 , DOI: 10.1038/sj.jhh.1001628
S Takiuchi 1 , K Kamide , Y Miwa , M Tomiyama , M Yoshii , T Matayoshi , T Horio , Y Kawano
Affiliation  

Carotid intima-media thickness (IMT) assessed by ultrasonography is regarded as an early predictor of general arteriosclerosis in patients with essential hypertension. However, the methods of measuring IMT have not been globally standardized, and it remains unclear whether conventional measurement of IMT represents the prevalence of hypertensive target organ damage. In this study, we verified the association between several commonly used carotid ultrasonographical parameters and the severity of hypertensive target organ damage (retinal arteriosclerosis, microalbuminuria, left ventricular hypertrophy (LVH)). Carotid ultrasonography, echocardiography, urinalysis, and funduscopy were performed in 184 patients (64 +/- 12 years, 96 males and 88 females) with various stages of essential hypertension. Carotid arteriosclerosis was assessed using four methodologically different methods: conventional-IMT, maximum-IMT (Max-IMT), Mean-IMT, and Plaque Score (the sum of all plaque thicknesses). Age and all carotid ultrasonographical parameters were significantly associated with albuminuria, retinal arteriosclerosis, and left ventricular mass index. High-sensitivity CRP was significantly correlated with retinopathy and LVH. Carotid parameters in patients with histories of cardiovascular events were significantly greater in those without events. Among all carotid parameters, Max-IMT showed the highest correlation coefficient of the severity of target organ damage, and showed significant association with CRP. Stepwise regression analysis revealed that Max-IMT was the independent factor for predicting target organ damage. Max-IMT is suggested to be the most reliable and simplest parameter for predicting hypertensive target organ damage including microangiopathy in patients with essential hypertension.

中文翻译:

颈动脉内膜中层厚度和斑块评分对预测原发性高血压患者靶器官损害的诊断价值。

通过超声检查评估的颈动脉内膜中层厚度(IMT)被认为是原发性高血压患者一般动脉硬化的早期预测指标。然而,测量 IMT 的方法尚未在全球范围内标准化,目前尚不清楚 IMT 的常规测量是否代表高血压靶器官损害的普遍性。在这项研究中,我们验证了几种常用的颈动脉超声参数与高血压靶器官损害严重程度(视网膜动脉硬化、微量白蛋白尿、左心室肥厚(LVH))之间的关联。对 184 名不同阶段的原发性高血压患者(64 +/- 12 岁,96 名男性和 88 名女性)进行了颈动脉超声检查、超声心动图检查、尿液分析和眼底检查。使用四种方法学上不同的方法评估颈动脉硬化:常规-IMT、最大-IMT (Max-IMT)、平均-IMT 和斑块评分(所有斑块厚度的总和)。年龄和所有颈动脉超声参数与蛋白尿、视网膜动脉硬化和左心室质量指数显着相关。高敏 CRP 与视网膜病变和 LVH 显着相关。有心血管事件史的患者的颈动脉参数在没有心血管事件的患者中显着更高。在所有颈动脉参数中,Max-IMT与靶器官损伤严重程度的相关系数最高,与CRP显着相关。逐步回归分析表明,Max-IMT是预测靶器官损伤的独立因素。
更新日期:2019-11-01
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