Lexicon
Carotid Intima-Media Thickness
Also known as CIMT
Definition
The carotid intima-media thickness (IMT) is a widely used surrogate marker for atherosclerosis that can be simply, noninvasively and reproducibly measured through B-mode carotid ultrasound. [1] CIMT is a validated predictive marker of increased plaque occurrence and of the incidence of major cardiovascular events. [2] CIMT is a strong predictor of coronary heart disease and an independent phenotype of early atherosclerosis. [3]
How it works
Increased carotid IMT is a common manifestation of generalized atherosclerosis and is closely associated with an increased risk of stroke and myocardial infarction. [4] Common carotid IMT increases progressively from normotensive to pre-hypertensive to hypertensive individuals, supporting its sensitivity to early vascular damage. [5] Regressions of increased carotid IMT with lipid-lowering and antihypertensive drugs have been reported. [1] The apoB-containing LOX-1 ligand (LAB) shows a significant positive association with carotid intima-media thickness independent of LDL cholesterol, and genome-wide analysis has identified APOB as a susceptibility locus for cIMT [6][7].
Connected concepts
How it's measured
Because of technical issues in measuring CIMT, a well-trained and certified sonographer is needed to overcome variability due to the patient, device, sonographer and quantification tool. [2] Comparison of IMT results across studies relies on harmonized approaches to carotid image acquisition and analysis, and the Mannheim consensus recommends against serial monitoring in individual patients. [8] Researchers must consider methodological aspects such as the definition of carotid plaques and the choice of measurement site on the common or internal carotid artery, and other parameters such as artery stenosis and plaque characteristics should also be assessed. [1]
What levels mean
In epidemiological studies increased carotid intima-media thickness has been defined as a thickness of 1.0 mm or more, carotid plaque as a focal thickness of 1.5 mm or more, and carotid stenosis as 50% or more. [9] In a meta-analysis the pooled mean CIMT for individuals without coronary heart disease was 0.65 mm, and it was significantly higher in those with coronary heart disease and in older persons. [3] A 1 standard deviation increase in CIMT was predictive of myocardial infarction and of stroke.
Community knowledge
## Imaging Protocols
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- 1.Nezu T, Hosomi N, Aoki S, Matsumoto M. Carotid Intima-Media Thickness for Atherosclerosis. J Atheroscler Thromb · 2016
- 2.Touboul PJ. Intima-media thickness of carotid arteries. Front Neurol Neurosci · 2015
- 3.Abeysuriya V, Perera BPR, Wickremasinghe AR. Regional and demographic variations of Carotid artery Intima and Media Thickness (CIMT): A Systematic review and meta-analysis. PLoS One · 2022
- 4.Kadoglou NP, Iliadis F, Liapis CD. Exercise and carotid atherosclerosis. Eur J Vasc Endovasc Surg · 2008
- 5.Cuspidi C, Sala C, Tadic M, Gherbesi E, Grassi G, Mancia G. Pre-hypertension and subclinical carotid damage: a meta-analysis. J Hum Hypertens · 2019
- 6.Sawamura T, Wakabayashi I, Okamura T. LOX-1 in atherosclerotic disease.
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