Clinical Application of Noninvasive Vascular Ultrasound in Cardiovascular Risk Stratification: A Report from the American Society of Echocardiography and the Society of Vascular Medicine and Biology

Mary J. Roman, Tasneem Z. Naqvi, Julius M. Gardin, Marie Gerhard-Herman, Michael Jaff, Emile Mohler

Research output: Contribution to journalArticle

126 Scopus citations

Abstract

Noninvasive measures of atherosclerosis have emerged as adjuncts to standard cardiovascular disease (CVD) risk factors in an attempt to refine risk stratification and the need for more aggressive preventive strategies. Two such approaches, carotid artery imaging and brachial artery reactivity testing (BART), are ultrasound based. Numerous carotid artery imaging protocols have been used, and methodologic aspects are described in detail in this review. The panel recommends that protocols: (1) use end-diastolic (minimum dimension) images for intimal-medial thickness (IMT) measurements; (2) provide separate categorization of plaque presence and IMT; (3) avoid use of a single upper limit of normal for IMT because the measure varies with age, sex, and race; and (4) incorporate lumen measurement, particularly when serial measurements are performed to account for changes in distending pressure. Protocols may vary in the number of segments wherein IMT is measured, whether near wall is measured in addition to far wall, and whether IMT measurements are derived from B-mode or M-mode images, depending on the application. BART is a technique that requires meticulous attention to patient preparation and methodologic detail. Its application is substantially more challenging than is carotid imaging and remains largely a research technique that is not readily translated into routine clinical practice.

Original languageEnglish (US)
Pages (from-to)943-954
Number of pages12
JournalJournal of the American Society of Echocardiography
Volume19
Issue number8
DOIs
StatePublished - Aug 1 2006

ASJC Scopus subject areas

  • Radiology Nuclear Medicine and imaging
  • Cardiology and Cardiovascular Medicine

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