Reproducibility of carotid intima-media thickness measurements in young adults

Purpose: To prospectively compare the reproducibility of carotid intima-media thickness (CIMT) measurements obtained from the right and left carotid arteries in young adults by using ultrasonographic (US) images acquired at the maximum dimension, minimum dimension, and electrocardiographically (ECG)-triggered cardiac end diastole. Materials and Methods: This study was HIPAA compliant and approved by the institutional review board; all participants provided informed consent. Medical history, anthropometric measurements, and blood pressure (BP) values were obtained from 50 men and 50 women aged 18-25 years. Images of the common carotid arteries were acquired from three independent complete cardiac cycles by using a 15L8-MHz US transducer. CIMT was measured on the images of each cycle that depicted the narrowest and widest vessel diameters, and at the R wave of the ECG. Measurements from the right and left carotid arteries were analyzed by using paired t tests; possible sex differences, by using unpaired t tests. Reproducibility was determined by using coefficients of variation and intraclass correlations (ICCs). Pearson correlations and multiple regression analyses were used to compare CIMT, body mass index (BMI), and BP. Results: CIMT values were 7.2% and 7% greater in frames showing the narrowest lumen diameter and in R-wave ECG-triggered frames, respectively, than in those with the widest diameter. CIMT measurements were 2.2%-3.1% greater in the right carotid artery than in the left (P < .001) and were significantly related to BMI (r = 0.40, P < .001) and systolic BP (r = 0.34, P < .001). ICCs were stronger when assessments were obtained in three different cardiac cycles (0.92-0.98), rather than in one (0.79-0.91). Conclusion: In healthy young adults, reproducibility of CIMT measurements is greatest when combining values from both carotid arteries and/or from the maximal and minimal arterial diameters.