Abstract
Background: Atherosclerosis has a systemic impact, producing gradual stenoses of the main vessels, and many imaging techniques have been developed in order to detect and quantify the atherosclerotic lesions. Peripheral artery disease has been shown to be associated with the presence of coronary heart disease, at the same time with carotid artery involvement. The utility of the carotid artery intima-media thickness (IMT) in predicting cardiovascular events caused by atherosclerosis, led to the idea that assessing the femoral artery IMT could have a similar impact.
Study aim: We sought to determine the correlations between the femoral IMT, the degree of left ventricular systolic dysfunction and cardiovascular risk factors in patients with established diagnosis of ischemic heart disease.
Material and methods: We prospectively included 27 patients with diagnosed ischemic heart disease. The ankle-brachial index (ABI) was assessed for the anterior and posterior tibial arteries. The left ventricular ejection fraction (LVEF) was determined by echocardiography. The femoral IMT was measured by peripheral vascular ultrasound, at the common femoral artery, 1 cm proximally from the bifurcation. The patients were divided into 2 groups: Group 1 – patients with IMT<0.9mm, and Group 2: patients with IMT >0.9 mm.
Results: The mean age of the study population was 65.52 ± 11.44 years, and 77.77% were males. The mean glycemia levels were 99.89 ± 30.34 mg/dl, total cholesterol: 176.81 ± 43.09 mg/dl and the mean triglyceride level 140 ± 65.12mg/dl. The mean LEVF was 49.98% ± 12.73%, and femoral IMT 0.75 mm ± 0.25 mm. IMT significantly correlated with cholesterol levels (R = 0.383, p = 0.048), anterior and posterior tibial artery pressures (R = 0.450, p = 0.018, R = 0.418, p = 0.029 respectively) and ABI (R = 0.623, p = 0.005). There was no significant correlation between the LVEF and the IMT (R = −0.143, p = 0.475). There was a significant difference between the 2 groups regarding the minimum anterior tibial artery pressure (95.57 mmHg vs. 63.5 mmHg, p = 0.0011) and the minimum ABI (0.85 vs. 0.5, p = 0.015), and the femoral IMT (p = 0.0001). For patients with a femoral IMT >0.9 mm, a significant correlation was found between ABI and femoral IMT (R = −0.710, p <0.0001).
Conclusion: The femoral intima-media thickness, assessed with peripheral vascular ultrasound, could be a new marker in evaluating the global cardiovascular risk in patients with ischemic heart disease. Femoral IMT could become a new marker for systemic atherosclerosis.