RESEARCH - Ultrasound screening reveals unknown cardiovascular risk in women

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Ultrasound screening reveals unknown cardiovascular risk in women

9/12/2006

By: Susman

Sonographic screening can correctly identify women who may be at risk of

heart disease or stroke, especially when traditional risk assessment methods

fall short, according to a presentation at the 2006 European Society of

Cardiology's World Congress of Cardiology in Barcelona, Spain.

While the Framingham risk score (FRS) system correlates well with men who

undergo ultrasound examinations of the carotid arteries and other vascular

beds, it does not appear to work as well in women, said study author Dr.

Postley, Jr., an assistant clinical professor of medicine at Columbia

University in New York City.

Instead, handheld ultrasound exams can give physicians a better idea as to

whether a woman at even the lowest risk for heart disease may still have

potential precursors to a heart attack, he said.

For this study, Postley looked 120 untreated patients, 50 of whom were

women. They all underwent sonographic evaluation for the presence and type

of carotid and femoral arterial bifurcation plaque (Titan; SonoCalc

software, SonoSite, Bothell, WA). Common carotid intimal medial thickness

(CIMT) was also measured.

A sonographic exam is capable of detecting differences of one-tenth of a

millimeter of thickness of the intimal layer of the artery, Postley

explained. The findings on ultrasound were then correlated with the

individual's FRS.

According to the results, 72% of the women had low FRS for cardiovascular

disease, yet half the women in the study showed evidence of plaque and

thickening of the endothelial lining of the carotid artery.

When CIMT measurements were divided according to gender, there was no

correlation for average CIMT or maximum CIMT among the women, Postley said,

while there was high correlation among the men.

" Clearly, a better method for risk-stratifying patients is needed so that

preventive treatment can begin for those who need it most, " Postley wrote in

his poster presentation. " Screening for carotid intimal medial thickness

with vascular ultrasound can uncover at-risk patients with greater accuracy

than traditional methods, and should allow for earlier intervention to

prevent progression of disease. "

" Screening vascular ultrasound analysis produces a different pattern of risk

assessment than does traditional Framingham risk analysis, particularly in

women, " Postley added.

He suggested that using ultrasound as an additional screening tool could

identify more women at risk of cardiovascular events.

" I would expect that private-care physicians -- either a family doctor or

doctors who specifically care for women -- would refer their patients to

radiologists to perform these ultrasound studies, " he said.

Commenting on the study, Dr. Sid , a professor medicine at the

University of North Carolina in Chapel Hill, said more studies were needed

before recommendations could be made about ultrasound screening. , who

is also a spokesman for the American Heart Association, said that future

studies would have to show that the findings of intimal thickening and

plaque streak in women do later correlate with adverse events, and that

treating these women, on the basis of those findings, reverses the risk.

By Susman

AuntMinnie.com contributing writer

September 12, 2006

http://www.auntminnie.com/index.asp?Sec=sup & Sub=wom & Pag=dis & ItemId=72356 & wf=1231

Not an MD

I'll tell you where to go!

Mayo Clinic in Rochester

http://www.mayoclinic.org/rochester

s Hopkins Medicine

http://www.hopkinsmedicine.org