WJCD  Vol.2 No.2 , April 2012
Determining factors for carotid mean/max intima-media thickness and brachial flow-mediated dilation in healthy young women
Background: Many factors can contribute to atherosclerotic-type vascular changes in older individuals or men. Thus, confining the investigation to young women with no clinical evidence of the condition could enhance understanding of the early stages of cardiovascular disease. The aim of this study was to determine whether carotid mean/max intima-media thickness (IMT) and brachial flow-mediated dilation (FMD) values, which are well-known event-related indices, are associated with laboratory data and the other vascular indices of atherosclerosis in healthy young women. Methods: Carotid mean/max IMT and brachial FMD were measured in young women with no clinical evidence of atherosclerosis (n = 110; mean age, 39 years) who were instructed not to eat, drink or smoke after 9 PM the evening before testing. All participants also underwent laboratory assessment, including simultaneous measurements of arterial stiffness such as augmentation index (AI), cardioankle vascular index (CAVI) and brachial-ankle pulse wave velocity (baPWV). Results: Mean IMT was signifi-cantly and positively associated with age (p = 0.002), CAVI (p = 0.044), low-density lipoprotein-cholesterol (LDL-C, p = 0.047) and high-sensitive C-reactive protein (hs-CRP, p = 0.002) values but was not related to FMD, AI, baPWV or triglycerides (TG) in the multivariate regression analysis. Similarly, max IMT was positively associated with age (p < 0.001), LDL-C (p = 0.003) and hs-CRP (p = 0.005) values but was not related to FMD, AI, CAVI, baPWV, TG or blood pressure level in the multivariate regression analysis. The association between LDL-C and max IMT was much stronger than that between LDL-C and mean IMT. Brachial FMD was positively associated only with heart rate in the multivariate regression analysis. Conclusions: These results suggest that mean IMT more closely represents the sclerotic aspect of vascular change, whereas max IMT represents the atherotic aspect in healthy young women. Although the relationship between the autonomic nervous system and heart rate is well-known, there may be a complex interaction between the autonomic nervous system and endothelial function.

Cite this paper
Hoshida, S. , Miki, T. , Nakagawa, T. , Shinoda, Y. and Adachi, T. (2012) Determining factors for carotid mean/max intima-media thickness and brachial flow-mediated dilation in healthy young women. World Journal of Cardiovascular Diseases, 2, 43-49. doi: 10.4236/wjcd.2012.22008.
[1]   Pignoli, P., Tremoli, E., Poli, A., et al. (1986) Intimal plus medial thickness of the arterial wall: A direct measurement with ultrasound imaging. Circulation, 74, 1399-1406. doi:10.1161/01.CIR.74.6.1399

[2]   Stein, J.H., Korcarz, C.E., Hurst, R.T., et al. (2008) Use of carotid ultrasound to identify subclinical vascular disease and evaluate cardiovascular disease risk: a consensus statement from the American society of echocardiogramphy carotid intima-media thickness task force. endorsed by the society for vascular medicine. Journal of American Society of Echocardiography, 21, 93-111. doi:10.1161/01.CIR.74.6.1399

[3]   Clarkson, P., Celermajer, D.S., Donald, A.E., et al. (1996) Impaired vascular reactivity in insulin-dependent diabetes mellitus is related to disease duration and low density lipoprotein cholesterol levels. Journal of American College of Cardiology, 28, 573-579. doi:10.1016/0735-1097(96)82380-1

[4]   Gokce, N., Holbrook, M., Duffy, S.J., et al. (2001) Effects of race and hypertension on flow-mediated and nitroglycerin-mediated dilation of the brachial artery. Hypertension, 38, 1349-1354. doi:10.1161/hy1201.096575

[5]   Cohn, J.N. (1999) Vascular wall function as a risk marker for cardiovascular disease. Journal of Hypertension, 17, S41-S44.

[6]   Lehmann, E.D. (1999) Clinical value of aortic pulse-wave velocity measurement. Lancet, 354, 528-529. doi:10.1016/S0140-6736(99)00179-8

[7]   Song, B.G., Park, J.B., Cho, S.J., et al. (2009) Pulse wave velocity is more closely associated with cardiovascular risk than augmentation index in the relatively low-risk population. Heart and Vessels, 24, 413-418. doi:10.1007/s00380-009-1146-1

[8]   Yambe, T., Yoshizawa, M., Saijo, Y., et al. (2004) Brachioankle pulse wave velocity and cardio-ankle vascular in- dex (CAVI). Biomedicine and Pharmacotherapy, 58, S95-S98.

[9]   Shirai, K., Utino, J., Otsuka, K., et al. (2006) A novel blood pressure-independent arterial wall stiffness parameter: Cardio-Ankle vascular index (CAVI). Journal of Atherosclerosis and Thrombosis, 13, 101-107. doi:10.5551/jat.13.101

[10]   Lorenz, M.W., Markus, H.S., Bots, M.L., et al. (2007) Prediction of clinical cardiovascular events with carotid intima-media thickness: A systematic review and meta- analysis. Circulation, 115, 459-467. doi:10.1161/CIRCULATIONAHA.106.628875

[11]   Yeboah, J., Folsom, A.R., Burke, G.L., et al. (2009) Pre- dictive value of brachial flow-mediated dilation for incident cardiovascular events in a population-based study: The multiethnic study of atherosclerosis. Circulation, 120, 502-509. doi:10.1161/CIRCULATIONAHA.109.864801

[12]   Yamasaki, Y., Kawamori, R., Matsushima, H., et al. (1994) Atherosclerosis in carotid artery of young IDDM patients monitored by ultrasound high-resolution B-mode imaging. Di-abetes, 43, 634-639. doi:10.2337/diabetes.43.5.634

[13]   Hoshida, S., Miki, T., Nakagawa, T., et al. (2011) Dif- ferent effects of isoflavones on vascular function in premenopausal and postmenopausal smokers and non-smokers: NYMPH study. Heart and Vessels, 26, 590-595. doi:10.1007/s00380-010-0103-3

[14]   Morrison, K.M., Dyal, L., Conner, W., et al. (2010) Cardiovascular risk factors and non-invasive assessment of subclinical atherosclerosis in youth. Atherosclerosis, 208, 501-505. doi:10.1016/j.atherosclerosis.2009.07.034

[15]   Hayaishi-Okano, R., Yamasaki, Y., Katakami, N., et al. (2002) Elevated C-reactive protein associates with early- stage carotid atherosclerosis in young subjects with type 1 diabetes. Diabetes Care, 25, 1432-1438. doi:10.2337/diacare.25.8.1432

[16]   Fitch, K.V., Stavrou, E., Looby, S.E., et al. (2011) Asso- ciations of cardiovascular risk factors with two surrogate markers of subclinical atherosclerosis: Endothelial func- tion and carotid intima media thickness. Atherosclerosis, 217, 437-440. doi:10.1016/j.atherosclerosis.2011.04.009

[17]   Ross, R. (1986) The pathogenesis of atherosclerosis—An update. New England Journal of Medicine, 8, 488-500. doi:10.1056/NEJM198602203140806

[18]   Celermajer, D.S., Sorensen, K.E., Gooch, V.M., et al. (1992) Non-Invasive detection of endothelial dysfunction in children and adults at risk of atherosclerosis. Lancet, 340, 1111-1115. doi:10.1016/0140-6736(92)93147-F

[19]   Benjamin, E.J., Larson, M.G., Keyes, M.J., et al. (2004) Clinical correlates and heritability of flow-mediated dila- tion in the community. The Framingham Heart Study. Circulation, 109, 613-619. doi:10.1161/01.CIR.0000112565.60887.1E

[20]   Fox, K., Borer, J.S., Camm, A.J., et al. (2007) Resting heart rate in cardiovascular disease. Journal of American College of Cardiology, 50, 823-830. doi:10.1016/j.jacc.2007.04.079

[21]   Celermajer, D.S., Sorensen, K.E., Bull, C., et al. (1994) Endothelium-dependent dilation in the systemic arteries of asymptomatic subjects relates to coronary risk factors and their interaction. Journal of American College of Cardiology, 24, 1468-1474. doi:10.1016/0735-1097(94)90141-4

[22]   Gokce, N., Holbrook, M., Hunter, L.M., et al. (2002) Acute effects of vasoactive drug treatment on brachial artery reactivity. Journal of American College of Cardi- ology, 40, 761-765. doi:10.1016/S0735-1097(02)02034-X

[23]   Custodis, F., Baumh?kel, M., Schlimmer, N., et al. (2008) Heart rate reduction by ivabradine reduces oxidative stress, improves endothelial function, and prevents atherosclerosis in apolipoprotein E-deficient mice. Circulation, 117, 2377-2387. doi:10.1161/CIRCULATIONAHA.107.746537

[24]   Hutcheson, I.R. and Griffith, T.M. (1991) Release of en- dothelium-dereived relaxing factor is modulated both by frequency and amplitude of pulsatile flow. American Journal of Physiology, 261, 257-262.

[25]   Harris, K.F. and Matthews, K.A. (2004) Interactions between autonomic nerve system activity and endothelial function: a model for the development of cardiovascular disease. Psychosomatic Medicine, 66, 153-164. doi:10.1097/01.psy.0000116719.95524.e2

[26]   Celermajer, D.S., Sorensen, K.E., Spiegelhalter, D.J., et al. (1994) Aging is associated with endothelial dysfunction in healthy men years before the age-related decline in women. Journal of American College of Cardiology, 24, 471-476. doi:10.1016/0735-1097(94)90305-0

[27]   Williams, M.R., Westerman, R.A., Kingwell, B.A., et al. (2001) Variations in endothelial function and arterial compliance during the menstrual cycle. Journal of Clinical Endocrinology and Metabolism, 86, 5389-5395. doi:10.1210/jc.86.11.5389