the egyptian society of cardiology board of ... - Cardioegypt.com

Ayman Sadek, et al
had documented obstruction of distal arteries of
the leg (Peripheral angiography or lower limb
arterial duplex).
The following patients were be excluded from the
whole study:
Previous neck or femoral irradiation, Previous
neck or femoral surgery, or any neck or lower limb
deformity interfering with carotid or femoral ultrasonography
respectively.
Methods:
Every patient was subjected to the following:
Proper history taking and examination:
Full history for the presence of cardiovascular
risk factors:
Smoking, Hypertension, Diabetes mellitus,
Dyslipidemia, Family history of ischemic heart
disease, Symptoms suggestive of coronary artery
diseases Peripheral vascular disease Cerebrovascular
strokes or transient ischemic attacks:
Complete general and local clinical examination
with stress on the following points:
Weight: Measured in kilograms.
Height: Measured in meters.
Body mass index = Weight in kilograms/(height
in meters) 2
Table 1: Criteria for clinical diagnosis of metabolic syndrome.
Measure
(any 3 of 5 constitute
diagnosis of metabolic
syndrome)
Elevated waist circumference*
Elevated triglycerides
Reduced HDL-C
Elevated blood pressure
Elevated fasting glucose
Categorical
Cutpoints
≥102 cm (≥40 inches) in
men ≥88 cm (≥35 inches)
in women
≥150 mg/dL (1.7
mmol/L)Or On drug
treatment for elevated
triglycerides
≤40 mg/dL (1.03 mmol/L)
in men≤50 mg/dL (1.3
mmol/L) in women
≥130 mm Hg systolic blood
pressure or ≥85 mm Hg
diastolic blood pressure
or On antihypertensive
drug treatment in a patient
with a history of
hypertension
≥100 mg/dL or On drug
treatment for elevated
glucose
41
Pulse: Radial, brachial with stress on pulse
pressure and dorsalis pedis arteries were examined
for rate, rhythm, volume, special character and
equality of pulsations.
Morning urine sample to measure microalbuminuria:
Using HemoCue Urine albumin operator
manuals instrument.
1- We open the package and carefully remove the
cuvette then we fill the cuvette by contact with
the urine sample (a urine drop on a hydrophilic
surface i.e a plastic film).
2- Open the lid and push the filled cuvette into the
cuvette holder.
3- Measuring should begin within 30 seconds after
the cuvette has been filled with urine.
4- Within 90 seconds the result will be displayed
in mg/dl.
12 lead surface ECG:
Echocardiography:
Echocardiography was done for measurement
of (LVEDD), (LVEDD, (EF), (LVPWT) and
(IVST).
And assessment of RSWMA.
Carotid and femoral arterial duplex:
All patients underwent ultrasonography of the
right and left carotid and femoral arteries where
the following measured:
1- Carotid intima-media thickness (IMT):
The characteristic B-scan pattern of the arterial
walls shows two parallel echogenic lines separated
by a relatively hypoechoic space "the double line
pattern". This pattern is found in the posterior wall
of the common carotid arteries; the inner line is
generally more regular, smooth and thin than the
outer one and represents the lumen intima interface.
The outer one is produced by the collagen containing
upper layer of tunica adventitia, close to the
media-adventitia interface.
The intima-media thickness (IMT) is measured
from the leading edge of the inner line to the
leading edge of the outer one [14].
An ultrasonographically determined increase
in IMT may be regarded as an indicator of generalized
atherosclerosis [15].
We measured the carotid IMT bilaterally by Bmode
ultrasonography (7-8MHz linear array, gen-