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What is CIMT (Carotid Intima Media Thickness) Testing ?Many patients suffering the early and intermediate stages of atherosclerosis show no outward signs or symptoms of the disease.
As many as 50% of those who died from CAD, had no prior signs or symptoms.
As many as 50% of those who died from CAD had cholesterol levels that met current guidelines.
• You could look inside your patients' arteries to see if they were covered in plaque?
• You could not only see the atherosclerotic burden, but could also predict your patient's risk of experiencing a Heart Attack, Stroke, or other Ischemic event.
• You could measure the degree of inflammation in the arterial wall or the size of the plaque that may contribute to the most common cause of death in America, heart disease?
Measuring the thickness of the intima and media layers of the carotid artery wall (carotid intima-media thickness, or CIMT) is one way to assess the cardiovascular health of your patients. CIMT is a non-invasive procedure and gives you another tool in your toolbox to further solve the diagnostic puzzle and help you you accurately assess disease presence, risk of events, and progression of the disease before your patient presents with acute symptoms.
The Framingham algorithm is a great tool for assessing patients at high and low risk for CAD. Establishing a treatment protocol for these patients is also relatively straight forward. However, what do we do for those patients who are at intermediate risk for CAD and who are asymptomatic? The standard of care says we should treat the symptoms of disease. Unfortunately, this may be grossly inadequate because many of these patients are already full of soft plaque (i.e. significant atherosclerosis), and have CIMT measurements that place them at very high risk for an ischemic event. Though many physicians will be uneasy with the uncertainty of the Framingham risk assessment in this medium risk group of patients, they will follow the standard of care and avoid aggressive pharmacological treatment in favor of maintaining a vigilant eye on these patients instead. Others will send these patients on for additional testing such as MRA, Stress Echo, or EBCT. Because very few of these patients will have more than 60% stenosis, they will pass the Stress Echo and MRA. EBCT is a great tool for assessing calcified plaque, but is inadequate at identifying the soft and more vulnerable plaque. Many of these patients still have significant amounts of soft plaque lining their arteries. Soft plaque (or echoluscent plaque) of any size has been shown to increase the odds ratio of an ischemic event nearly 2.5 times higher than a person who has an old MI. (Honda, et al J AM Coll Cardiol 2004; 43:1177-84)
CIMT measurements using B-mode (brightness mode) ultrasound have been performed since the mid-1980s. Using structural B-mode ultrasound, a CIMT-trained sonographer can easily and non-invasively acquire images of the carotid artery wall for analysis, typically the region immediately proximal to the bifurcation. Upon examination via ultrasound, the adventitia shows up as a bright, white layer and the blood-filled lumen shows up as a black area, allowing the clinician to isolate the area of interest in between . . . the CIMT. CardioRisk's sonographers are all trained to use our patented protocol using patented CIMT software. A CardioRisk trained and experienced sonographer can complete the CIMT procedure in just under ten minutes of your patient's time.
We believe . . . One Full Day of Carotid Intima-Media Thickness (CIMT) testing (approximately 20 patients) will provide you with the necessary performance-based clinical data you need to retain CardioRisk as your CIMT provider of choice.
If you'd like to have more clinical evidence on CIMT and how it correlates to other risk factors, its predictive value for assessing subclinical disease, or how it is being used in current studies . . . or if you'd like a CardioRisk representative to contact you please call us at: 888.724.7484 extension 705. or click here.