Non-invasive assessment of atherosclerosis

Non Invasive assessment techniques of atherosclerosis include Pulse-wave velocity at the brachial artery, Intima media thickness (IMT) in the carotid artery, Multi (64)-slice computed tomography (MSCT) for imaging of coronary lesions, Arterial pulse wave form analysis, Ankle Brachial Index (ABI) and Computed Tomography for coronary calcium. The potentially applicable screening tools have to be simple, reproducible, widely applicable and independently able to predict risk. Carotid IMT testing using ultrasound imaging of the carotid artery far wall and all carotid segments with carotid plaque assessment is an important study for prognostication of future coronary vascular (CV) events, risk of stroke and MI. Carotid IMT has also been shown to correlate well in Indian studies with other risk factors such as microalbuminuria and apolipoprotein B. Flow-mediated dilatation (FMD) of the brachial artery also correlates with other noninvasive measures of cardiovascular risk, including CRP, carotid IMT, and measures of arterial stiffness. Non-invasive assessment of endothelial dysfunction by FMD has shown to be useful in prediction of coronary artery disease in Indian subjects The most commonly studied measures of arterial stiffness are aortic pulse wave velocity (PWV) and pulse wave analyses such as the aortic augmentation index. Non-invasive assessment of arterial stiffness by vascular profiler has shown a close correlation with the FMD assessment of endothelial dysfunction. Presence of coronary calcium on the cardiac CT scan has an excellent correlation with future coronary events and contrast-enhanced coronary CT with near 100% negative predictive value for presence of coronary lesions. The Carotid artery Right side Normal artery Damage artery Intime-media thickness Figure 1 Ultrasound measurement of Carotid IMT Figure 3 Carotid artery Doppler for measuring IMT Ultrasound measurement of CIMT