Ultrasonographic findings as cardiovascular predictors

January 01, 0001

Ultrasonographic findings as cardiovascular predictors

Practitioners exert considerable effort in classifying patients cardiovascular risk. These Canadian researchers examined the prognostic significance value of endothelial function along with vascular markers in healthy adult males via a cohort study. The cohort was composed of disease free males (n=157, median Framingham risk score=7.9%), and they underwent measurement of flow-mediated dilation, hyperemic velocity, carotid intima- media thickness, and C-reactive protein.

The researchers found: "Cardiovascular events occurred in 71 subjects (111 events) over a mean follow-up of 7.2±1.7 years. Flow-mediated dilation was not associated with subsequent cardiovascular events (hazard ratio, 0.92). Both hyperemic velocity (hazard ratio, 0.70) and carotid intima-media thickness (hazard ratio, 1.45) but not C-reactive protein (P=0.35) were related to events in a multivariable analysis that included Framingham risk score (per unit SD). Furthermore, the addition of hyperemic velocity to Framingham risk score resulted in a net clinical reclassification improvement of 28.7% after 5 years of follow-up in the intermediate-risk group. Overall net reclassification improvement for hyperemic velocity was 6.9%."

The researchers concluded: "In men, hyperemic velocity, the stimulus for flow-mediated dilation, but not flow-mediated dilation itself was a significant risk marker for adverse cardiovascular outcomes. The prognostic value was additive to traditional risk factors and carotid intima-media thickness. Hyperemic velocity, a newly described marker of microvascular function, is a novel tool that may improve risk stratification of lower-risk healthy men."

Ultrasonographic findings may help determining cardiovascular risk when combined with the traditional risk factors

For the full abstract, click here.

Circulation 123(2):163-169, 18 January 2011
© 2011 to the American Heart Association, Inc.
Microvascular Function Predicts Cardiovascular Events in Primary Prevention: Long-Term Results From the Firefighters and Their Endothelium (FATE) Study. Todd J. Anderson, Francois Charbonneau, Lawrence M. Title. Correspondence to Todd J. Anderson: [email protected]

Category: K. Circulatory. Keywords: intima thickening, velocity, ultrasonography, Framingham risk, FATE study, cohort study, journal watch.
Synopsis edited by Dr Paul Schaefer, Toledo, Ohio. Posted on Global Family Doctor 15 February 2011

Pearls are an independent product of the Cochrane primary care group and are meant for educational use and not to guide clinical care.