X. Castellon, V. Bogdanova

The study was carried in Athis Mons France between 2008 and the early 2011 on a cohort of 350 patients with cardiovascular risk factors. Introduction: Atherosclerotic lesions increase with aging and the changes favored by risk factors (diabetes, obesity, hypertension, dyslipidemia, smoking) and hence the interest of making an early detection of sub clinical atherosclerosis. The study of intima media thickness and speed of the wave pulse based on age, can detect patients at risk with increased threshold values, which reflects early atherosclerotic impregnation of the arterial wall. This screening at the present time is feasible and desirable for a preventive purpose, since the advent of the radio frequency coupled with 2D ultrasound. Purpose: Early detection of sub clinical atherosclerosis by studying the changes in the arterial wall and geometric radio frequency (RF) coupled with the 2D echo, through the analysis of cut-off values of IMT (intima media thickness) and VPW (velocity of pulse wave) of after age in patients with cardiovascular risk factors. Inclusion criteria: patients with cardiovascular risk factors (dyslipidemia, type II diabetes uncomplicated, hypertension, smoking and overweight) untreated or not controlled by the treatment. Exclusion criteria: healthy patients or with a history of established cardiovascular disease and patients with pathological values of IMT≥900 microns and a VPW≥12 m/s. Methods: Comparative study of 350 patients (225 men,125 women), average age of 51 years, divided into 2 main groups, with 2 methods performed (QIMT, QAS). The patients included have had a study of the remodeling of the arterial wall (functional and geometric) by RF coupled with 2D. The parameters studied, threshold values of intima media thickness (IMT) and velocity of pulse (VPW) by age group. Techniques: The QIMT: measurement of intima-media thickness (IMT), according to the protocol of Mannheim. The QAS: measurement of the velocity of pulse (VPW), according to the Protocol of Athis-Mons. Groups studied: Group (QAS) 200 patients between 20-69 years, divided into two subgroups: A) first sub group: 125 men (120 white / 5 black race), with risk factors of dyslipidemia, diabetes and smoking. B) second sub group: 75 white women with risk factors of hypertension and overweight. Results: The analysis of the data obtained shows that 35.3% of men and 20.1% of women have abnormal results above the threshold values. Among the different sub groups, 30.3% (men) and 12.1% (women) with dyslipidemia and smoking as risk factors predominate. The group at highest risk is between 40-59 years with a high percentage of abnormal results. A prevalence of pathological results is strongly linked with the male gender, increase in age and the presence of the risk factors such as smoking and dyslipidemia. There is no difference for abnormal results between race and gender in relation to the velocity of pulse (VPW); In the final analysis of all the groups, 55.4% of the patients included in the study had abnormal results, among them 40% with several risk factors are inadequately controlled by the treatment and 15% of remaining listed as non-treated patients. Conclusion: The sub clinical atherosclerosis detection is possible at the present time with the emergence of new techniques such as QIMT, QAS by Radio frequency (RF), easy to use and reproducible results with a sensitivity of 95% and a specificity of 94%. They can be calculated in real time and to codify the thresholds values of IMT and VPW according to the age group of patients with risk factors. The results of each patient must be systematically associated with the technique of the FMV ( flow-mediated vasodilatation) to detect Endothelial dysfunction and also associated with the biological, biochemical markers and oxidative stress. The application of the new Protocol of early detection of atherosclerosis allows us to identify patients at risk and to support targeted and tailored to each patient. This study allowed us to codify the threshold values of the arterial stiffness and ADR according to age and stratify the risk of earlier patients. Comments: 55.4% of the patients with abnormal results above the threshold values, are patients who deserve a more targeted and aggressive support finally reduce the progression of atherosclerosis, slow the aging of the artery, standardize the threshold values and reduce the occurrence of cardiovascular events.

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Early detection