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July2004 Vol.41 Issue:      2 Table of Contents
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Carotid intima – media thickness assessment as subclinical marker of both coronary and cerebro-vascular atherosclerosis

Mahassen Ali Hassan1, Sadek Helmy1, Adel Hassanein1,

Manal El Kattan1, Fathy Fouad2, Foad Abd Allah1

Department of Neurology, Cairo University1, Zagazig University2


In the present study, we used high resolution B-mode and color coded duplex ultrasound to detect the degree of intima-media thickness of common carotid artery in the two groups of patients (group I and group II). The aim was to study the relationship between ischaemic heart disease and (1) subclinical atherosclerosis by measuring the intima media thickness (IMT) of the common carotid artery (CCA) (2) Established atherosclerosis by detecting the presence of  atherosclerotic plaques and estimate the degree of stenosis, in both groups of patients. Ischaemic heart disease patients with neurological manifestations (group I) and ischaemic heart disease without neurological manifestations (group II). Age was positively correlated with mean intima media thickness (IMT) in both groups of patients reaching a high significant level p value < 0.001. Regarding sex distribution, there were 56 males and 24 females. Male patients showed high levels of intima media thickness more than female patients where mean intima media thickness 11.62±2.868 and 10.190±2.015 in males in group I and II respectively opposite to 8.0806±1.927 and 8.333±7.414 in females in group I and II respectively and such difference reached a statistically significant level p value < 0.05. Correlating severity of ischaemic heart disease (IHD) taking ejection fraction of the heart (EF) as indicator of heart condition with degree of intima media thickness, it was found that it is positively correlated in group II only (p value = 0.024). Positive correlations were found between number of smokers and mean intima media thickness reaching significant level in both groups being more significant in group II. Hypertension was the commonest identified risk factors  in group I. Fasting blood sugar and postprandial blood sugar positively  correlated to degree of intima media thickness in group I (p value< 0.05). The level of triglycerides was positively correlated to intima media thickness with a statistically significant level, while HDL, LDL and cholesterol showed no significant correlations in both group I and II. Cervical bruit in 42.5% of patients was found to be highly and positively correlated with results of both carotid duplex and neck MRA where p value < 0.05 in both groups of patients on the other hand no positive correlation was found between cervical bruit and mean intima media thickness. There was a significant agreement between carotid duplex and neck MRA, where kappa = 0.598 and p< 0.001. Neck MRA detect 81.8% of normal carotids diagnosed by duplex. On the other hand, it detected 78.6% of diseased vessels diagnosed by duplex study. Regarding MRI study in the present work more patients were discovered in both groups to have lesions than found by CT scanning.

(Egypt J. Neurol. Psychiat. Neurosurg., 2004, 41(2): 509-520).


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