Abstract
Background: Although carotid intima-media thickness (IMT) is the most commonly used ultrasonic measurement of atherosclerosis, plaque burden can be also assessed by ultrasound (US). We investigated the relationship between IMT, total plaque area (TPA) and total plaque volume (TPV) in patients with coronary artery disease (CAD). Methods: One hundred and seven patients with suspected CAD and carotid plaques identified by duplex ultrasound underwent 3-dimensional US and coronary angiography. The mean IMT, TPA, and TPV were analyzed for patients with CAD according to the severity of CAD. Results: In the 107 participants, IMT, TPA and TPV averaged $0.90{\pm}0.26mm$, $0.42{\pm}0.39cm^2$ and $237.0{\pm}301.2mm^3$, respectively. We found significant correlations for mean IMT : TPA, mean IMT : TPV and TPA : TPV of 0.448, 0.587 and 0.873, respectively (all p < 0.005). Although there was no significant association of IMT and the severity of CAD, TPA and TPV showed significant positive correlation with CAD severity (r = 0.340, p = 0.0003 for TPA and r = 0.465, p < 0.0001 for TPV). Multivariate linear regression analysis showed age was the only significant attributor to IMT, TPA, and TPV. Mean IMT was significantly associated only with hypertension. TPA was significantly associated with male sex, hypertension, and low density lipoprotein-cholesterol (LDL-C). TPV was significantly associated with male sex, C-reactive protein, and LDL-C. Conclusion: Although there were significant correlations among the various US measures of carotid artery morphology, there seemed to be different biological determinants of IMT, TPA, and TPV. We might need to be selective about the particular measurements for specific applications.
