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J Clin Med. 2019 Aug 12;8(8). pii: E1201. doi: 10.3390/jcm8081201.

Natural History of Atherosclerosis and Abdominal Aortic Intima-Media Thickness: Rationale, Evidence, and Best Practice for Detection of Atherosclerosis in the Young.

Author information

1
Boden Collaboration for Obesity, Nutrition, Exercise and Eating Disorders, Charles Perkins Centre, The University of Sydney, Sydney 2006, Australia. michael.skilton@sydney.edu.au.
2
Sydney Medical School, Faculty of Medicine and Health, The University of Sydney, Sydney 2006, Australia. michael.skilton@sydney.edu.au.
3
Sydney Medical School, Faculty of Medicine and Health, The University of Sydney, Sydney 2006, Australia.
4
Department of Woman's and Child's Health, Obstetrics and Gynecology Clinic, University of Padua, 35128 Padova, Italy.
5
BCNatal-Barcelona Center for Maternal-Fetal and Neonatal Medicine (Hospital Clínic and Hospital Sant Joan de Deu), 08028 Barcelona, Spain.
6
Institut d'Investigacions Biomèdiques August Pi i Sunyer, Universitat de Barcelona, 08036 Barcelona, Spain.
7
Centre for Biomedical Research on Rare Diseases (CIBER-ER), 28029 Madrid, Spain.
8
FH Foundation, Pasadena, CA 91106, USA.
9
Centre for Population Health Research, University of Turku and Turku University Hospital, FIN-20520 Turku, Finland.
10
Research Centre of Applied and Preventive Cardiovascular Medicine, University of Turku, FIN-20520 Turku, Finland.
11
Department of Clinical Physiology and Nuclear Medicine, Turku University Hospital, FIN-20520 Turku, Finland.
12
Heart Institute, Cincinnati Children's Hospital, University of Cincinnati, Cincinnati, OH 45229, USA.

Abstract

Atherosclerosis underlies most myocardial infarctions and ischemic strokes. The timing of onset and the rate of progression of atherosclerosis differ between individuals and among arterial sites. Physical manifestations of atherosclerosis may begin in early life, particularly in the abdominal aorta. Measurement of the abdominal aortic intima-media thickness by external ultrasound is a non-invasive methodology for quantifying the extent and severity of early atherosclerosis in children, adolescents, and young adults. This review provides an evidence-based rationale for the assessment of abdominal aortic intima-media thickness-particularly as an age-appropriate methodology for studying the natural history of atherosclerosis in the young in comparison to other methodologies-establishes best practice methods for assessing abdominal aortic intima-media thickness, and identifies key gaps in the literature, including those that will identify the clinical relevance of this measure.

KEYWORDS:

aorta; atherosclerosis; intima-media thickness; ultrasound

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