Assessment of intima-media complex in carotid, femoral and right subclavian arteries for early investigation of atherosclerosis in HIV-infected patients

Godoi, Emmanuelle Tenório Albuquerque Madruga; Brandt, Carlos Teixeira; Godoi, Jocelene Tenório Albuquerque Madruga; Melo, Heloísa Ramos Lacerda de; Godoi, Juannicelle Tenório Albuquerque Madruga

doi:10.1590/S0100-39842013000600004

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Sumário

Original Articles • Radiol. Bras. 46 (6) • Nov-Dec 2013 • https://doi.org/10.1590/S0100-39842013000600004 copy

Assessment of intima-media complex in carotid, femoral and right subclavian arteries for early investigation of atherosclerosis in HIV-infected patients^* * Study developed at Hospital das Clínicas da Universidade Federal de Pernambuco (UFPE), Recife, PE, Brazil.

Authorship SCIMAGO INSTITUTIONS RANKINGS

Objective

To compare automatic and manual measurements of intima-media complex (IMC) in common carotid, common femoral and right subclavian arteries of HIV-infected patients in relation to a control group, taking into consideration the classical risk factors for atherosclerosis.

Materials and Methods

The study sample comprised 70 HIV-infected patients and 70 non-HIV-infected controls paired according sex and age. Automatic (gold standard) and manual measurements of IMC were performed in the carotid arteries. Manual measurements were also performed in common femoral and right subclavian arteries. Bland-Altman graphs were utilized in the comparison and the adopted level significance was 5%.

Results

Intima-media complex alterations were not observed in any of the individuals as the mean automatic measurement in the right common carotid (RCC) artery was considered as the gold standard. As the gold standard was compared with the manual measurements (mean, maximum and minimum), no clinically significant alteration was observed. As the gold standard was compared with other sites, the difference was statistically and clinically significant at the origin of right subclavian artery (RCC: 0.51 mm vs. 0.91 mm) (p < 0.001).

Conclusion

HIV-infected individuals are not at higher risk for atherosclerosis than the control population.

Atherosclerosis; Intima-media complex; Automatic; Subclavian; Femoral

Publicação do Colégio Brasileiro de Radiologia e Diagnóstico por Imagem Av. Paulista, 37 - 7º andar - conjunto 71, 01311-902 - São Paulo - SP, Tel.: +55 11 3372-4541, Fax: 3285-1690, Fax: +55 11 3285-1690 - São Paulo - SP - Brazil
E-mail: radiologiabrasileira@cbr.org.br

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[1] Dra. Emmanuelle Tenório Albuquerque Madruga Godoi. Rua Marquês de Tamandaré, 162, ap. 1402, Poço da Panela. Recife, PE, Brazil, 52061-170. E-mail: godoiemmanuelle@hotmail.com.

Variables	Groups				Total
	HIV patients		Control		Total
	n	%	n	%	n	%
Smoking	12	17.1	12	17.1	24	17.1
SAH	11	15.7	13	18.6	24	17.1
Increased cholesterol	25	35.7	3	4.3	28	20.0
Increased triglyceride	32	45.7	4	5.8	36	25.9
BMI
Normal (< 25)	45	64.3	30	42.9	75	53.6
Overweight (25-29,9)	20	28.6	28	40.0	48	34.3
Obesity (≥ 30)	5	7.1	12	17.1	17	12.1
AC
Normal	60	85.7	46	65.7	106	75.7
Altered	10	14.3	24	34.3	34	24.3
Age (years) - mean ± SD	40.5 ± 6.0	-	40.8 ± 6.4	-	p = 0.838	-
Male	42	60.0	42	60.0	p > 0.999	-
Smoking	12	17.1	12	17.1	p > 0.999	-
SAH	11	15.7	13	18.6	p = 0.654	-
Increased cholesterol	25	35.7	3	4.3	p < 0.001^* * Statistically significance.	-
Increased triglyceride	32	45.7	4	5.8	p < 0.001^* * Statistically significance.	-
Increased BMI	25	35.7	40	57.1	p = 0.027^* * Statistically significance.	-
Increased AC	10	14.3	24	34.3	p = 0.006^* * Statistically significance.	-

	Mean (SD)	Mean difference (CI 95%)	Difference < 0.10 mm (%)	CCA (CI 95%)	p-value
RCC mean automatic	0.51 (0.08)	−0.030	80.0%	0.581	0.010^* * Statistically significance.
RCC mean manual	0.53 (0.10)	(−0.18 ; 0.13)	80.0%	(0.418 ; 0.708)	0.010^* * Statistically significance.
RCC mean automatic	0.51 (0.08)	−0.072	65.7%	0.489	< 0.001^* * Statistically significance.
RCC maximum manual	0.58 (0.09)	(−0.20 ; −0.06)	65.7%	(0.346 ; 0.609)	< 0.001^* * Statistically significance.
RCC mean automatic	0.51 (0.08)	0.008	87.1%	0.676	0.313
RCC minimum manual	0.50 (0.09)	(−0.12 ; 0.14)	87.1%	(0.529 ; 0.784)	0.313
RCC mean automatic	0.51 (0.08)	−0.400	7.1%	0.019	< 0.001^* * Statistically significance.
Right subclavian artery origin	0.91 (0.18)	(−0.75 ; −0.04)	7.1%	(0.002 ; 0.053)	< 0.001^* * Statistically significance.
RCC mean automatic	0.51 (0.08)	−0.050	60.0%	0.334	< 0.001^* * Statistically significance.
Median right subclavian artery	0.56 (0.13)	(−0.28 ; 0.19)	60.0%	(0.158 ; 0.489)	< 0.001^* * Statistically significance.
RCC mean automatic	0.51 (0.08)	−0.040	58.6%	0.215	0.019^* * Statistically significance.
RCFA	0.55 (0.12)	(−0.28 ; 0.21)	58.6%	(0.015 ; 0.398)	0.019^* * Statistically significance.
LCC mean automatic	0.52 (0.09)	−0.044	80.0%	0.675	< 0.001^* * Statistically significance.
LCC mean manual	0.57 (0.08)	(−0.16 ; 0.07)	80.0%	(0.545 ; 0.774)	< 0.001^* * Statistically significance.
LCC mean automatic	0.52 (0.09)	−0.089	52.9%	0.518	< 0.001^* * Statistically significance.
LCC maximum manual	0.61 (0.09)	(−0.21 ; 0.03)	52.9%	(0.391 ; 0.626)	< 0.001^* * Statistically significance.
LCC mean automatic	0.52 (0.09)	−0.002	85.7%	0.712	0.787
LCC minimum manual	0.52 (0.09)	(−0.13 ; 0.12)	85.7%	(0.574 ; 0.810)	0.787
LCC mean automatic	0.52 (0.09)	−0.040	58.6%	0.207	0.002^* * Statistically significance.
LCFA	0.57 (0.10)	(−0.28 ; 0.19)	58.6%	(0.001 ; 0.398)	0.002^* * Statistically significance.

	Mean (SD)	Mean difference (CI 95%)	Difference < 0.10 mm (%)	CCA (CI 95%)	p-value
RCC mean automatic	0.51 (0.08)	−0.048	78.6%	0.732	< 0.001^* * Statistically significance.
RCC mean manual	0.56 (0.10)	(−0.15 ; 0.05)	78.6%	(0.632 ; 0.814)	< 0.001^* * Statistically significance.
RCC mean automatic	0.51 (0.08)	−0.088	54.3%	0.566	< 0.001^* * Statistically significance.
RCC maximum manual	0.60 (0.11)	(−0.21 ; 0.03)	54.3%	(0.452 ; 0.662)	< 0.001^* * Statistically significance.
RCC mean automatic	0.51 (0.08)	−0.017	91.4%	0.782	0.017^* * Statistically significance.
RCC minimum manual	0.53 (0.10)	(−0.13 ; 0.09)	91.4%	(0.678 ; 0.855)	0.017^* * Statistically significance.
RCC mean automatic	0.51 (0.08)	−0.460	0.0%	0.038	< 0.001^* * Statistically significance.
Right subclavian artery origin	0.97 (0.18)	(−0.79 ; −0.13)	0.0%	(0.009 ; 0.066)	< 0.001^* * Statistically significance.
RCC mean automatic	0.51 (0.08)	−0.070	58.6%	0.298	< 0.001^* * Statistically significance.
Median right subclavian artery	0.58 (0.11)	(−0.27 ; 0.14)	58.6%	(0.121 ; 0.457)	< 0.001^* * Statistically significance.
RCC mean automatic	0.51 (0.08)	−0.070	48.6%	0.188	< 0.001^* * Statistically significance.
RCFA	0.58 (0.13)	(−0.33 ; 0.19)	48.6%	(0.012 ; 0.352)	< 0.001^* * Statistically significance.
LCC mean automatic	0.54 (0.08)	−0.044	84.3%	0.770	< 0.001^* * Statistically significance.
LCC mean manual	0.59 (0.09)	(−0.13 ; 0.04)	84.3%	(0.674 ; 0.841)	< 0.001^* * Statistically significance.
LCC mean automatic	0.54 (0.08)	−0.084	54.3%	0.582	< 0.001^* * Statistically significance.
LCC maximum manual	0.63 (0.10)	(−0.19 ; 0.02)	54.3%	(0.466 ; 0.678)	< 0.001^* * Statistically significance.
LCC mean automatic	0.54 (0.08)	−0.007	90.0%	0.801	0.296
LCC minimum manual	0.55 (0.09)	(−0.12 ; 0.10)	90.0%	(0.702 ; 0.869)	0.296
LCC mean automatic	0.54 (0.08)	−0.040	67.1%	0.454	< 0.001^* * Statistically significance.
LCFA	0.58 (0.11)	(−0.22 ; 0.15)	67.1%	(0.268 ; 0.607)	< 0.001^* * Statistically significance.

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Assessment of intima-media complex in carotid, femoral and right subclavian arteries for early investigation of atherosclerosis in HIV-infected patients* * Study developed at Hospital das Clínicas da Universidade Federal de Pernambuco (UFPE), Recife, PE, Brazil.

Objective

Materials and Methods

Results

Conclusion

Assessment of intima-media complex in carotid, femoral and right subclavian arteries for early investigation of atherosclerosis in HIV-infected patients^* * Study developed at Hospital das Clínicas da Universidade Federal de Pernambuco (UFPE), Recife, PE, Brazil.