ASSESSMENT OF CARDIOVASCULAR RISK: Measurement of the intima-media thickness in the carotid artery is optimized by coupling high-resolution ultrasonography with automatic data processing systems, allowing improved precision. Although the optimal site of measurement remains controversial (common carotid, bifurcation, internal carotid), there appears to be a consensus on need for bilateral automatic measurement. The intima-media thickness is considered a marker of atheromatous disease and its diffusion. This parameter probably integrates the deleterious effect of different cardiovascular risk factors accumulated over decades. In addition, several prospective observation studies have reported a positive relationship between measurement of the intima-media thickness of the carotid artery and risk of cardiovascular events (myocardial infarction and stroke).
Detection aid: Although the results issuing from epidemiology observation studies are still too preliminary, to evaluate the positive and negative predictive value for occurrence of clinical events in relation to different levels of thickness, this simple rapid and noninvasive measurement could be a useful tool for subjects with high cardiovascular risk.
Perspectives: Measurement of arterial parameters, determined by high-resolution ultrasonography, will probably shortly become an integral part of the evaluation strategies for cardiovascular risk. Future comparative studies will provide an assessment of the comparative predictive value of these different parameters (quantitative structural analysis versus quantitative and qualitative analysis of the structure versus structural and functional analysis of the arteries).