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Näslund, Ulf
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Publications (10 of 113) Show all publications
Mickelsson, M., Ekblom, K., Stefansson, K., Liv, P., Nyman, E., Själander, A., . . . Hultdin, J. (2024). ABO blood groups, RhD factor and their association with subclinical atherosclerosis assessed by carotid ultrasonography. Journal of Clinical Medicine, 13(5), Article ID 1333.
Open this publication in new window or tab >>ABO blood groups, RhD factor and their association with subclinical atherosclerosis assessed by carotid ultrasonography
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2024 (English)In: Journal of Clinical Medicine, E-ISSN 2077-0383, Vol. 13, no 5, article id 1333Article in journal (Refereed) Published
Abstract [en]

Background: The ABO blood group system has previously been associated with cardiovascular disease (CVD), where non-O blood group individuals have shown an increased risk. Studies assessing early atherosclerotic disease while also including RhD are few. We aimed to determine whether the ABO and RhD blood groups are associated with subclinical atherosclerosis in a healthy population.

Methods: We included 3532 participants from the VIPVIZA trial with available carotid ultrasonography results to assess subclinical disease. Information about blood groups was obtained from the SCANDAT-3 database, where 85% of VIPVIZA participants were registered.

Results: RhD− individuals aged 40 years showed increased carotid intima–media thickness (B 1.09 CI 95% 1.03; 1.14) compared to RhD+ individuals. For ABO, there were no differences in ultrasonography results when assessing the whole study population. However, 60-year-old individuals with heredity for CVD and a non-O blood group had decreased odds for carotid plaques (OR 0.54 CI 95% 0.33; 0.88).

Conclusions: RhD blood group is associated with subclinical atherosclerosis in younger individuals, indicating a role as a mediator in the atherosclerotic process. In addition, a non-O blood group was associated with decreased subclinical atherosclerosis in individuals aged 60 and with heredity (corresponding to the group with the highest atherosclerotic burden).

Place, publisher, year, edition, pages
MDPI, 2024
Keywords
ABO blood group system, atherosclerosis, cardiovascular prevention, carotid intima–media thickness, carotid plaques, RhD factor
National Category
Cardiac and Cardiovascular Systems Hematology
Identifiers
urn:nbn:se:umu:diva-222584 (URN)10.3390/jcm13051333 (DOI)001182882700001 ()2-s2.0-85187443119 (Scopus ID)
Funder
Visare Norr, Dnr 981146Region Västerbotten, ALFVLL-298001Region Västerbotten, AALFVLL-643391Swedish Research Council, 521-2013-2708Swedish Research Council, 2016-01891Swedish Heart Lung Foundation, 20150369Swedish Heart Lung Foundation, 20170481
Available from: 2024-04-08 Created: 2024-04-08 Last updated: 2024-04-08Bibliographically approved
Andersson, E. M., Liv, P., Nordin, S., Näslund, U. & Lindvall, K. (2024). Does a multi-component intervention including pictorial risk communication about subclinical atherosclerosis improve perceptions of cardiovascular disease risk without deteriorating efficacy beliefs?. Social Science and Medicine, 341, Article ID 116530.
Open this publication in new window or tab >>Does a multi-component intervention including pictorial risk communication about subclinical atherosclerosis improve perceptions of cardiovascular disease risk without deteriorating efficacy beliefs?
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2024 (English)In: Social Science and Medicine, ISSN 0277-9536, E-ISSN 1873-5347, Vol. 341, article id 116530Article in journal (Refereed) Published
Abstract [en]

Background: Pictorial communication about subclinical atherosclerosis can improve cardiovascular disease (CVD) risk, but whether it leads to long-term shifts in self-rated CVD risk (risk perception) and beliefs about possibility to influence personal risk (efficacy beliefs) is unknown.

Purpose: To study the impact of personalized color-coded and age-related risk communication about atherosclerosis and motivational conversation, compared to traditional risk factor-based communication, on risk perception and efficacy beliefs. Also, whether risk perception increases with message severity.

Method: The effect of the pragmatic RCT Visualization of Asymptomatic Atherosclerotic Disease for Optimum Cardiovascular Prevention (VIPVIZA) was analyzed using a linear mixed effects model with risk perception and efficacy believes at 1-year and 3-year follow up as dependent variables. Participants’ (n = 3532) CVD risk perception and efficacy beliefs were assessed with visual analog scales (0–10). Fixed effects were group (intervention vs control), time point (1 year or 3 years) and interaction between group and time point. Further, the models were adjusted for corresponding baseline measurement of the dependent variable and a baseline × time point interaction. Effect of pictorial color-coded risk in the intervention group was investigated using a corresponding mixed effects model, but with pictorial risk group (message severity) as exposure instead of intervention group.

Results: After one year, the intervention group rated their CVD risk as higher (m = 0.46, 95% CI 0.32–0.59), with an effect also after 3 years (m = 0.57, 95% CI 0.43–0.70). The effect was consistent in stratified analyses by sex and education. Overall, no effect on efficacy beliefs was observed. In the intervention group, differences in CVD risk perception were found between participants with different color-coded risk messages on atherosclerosis status.

Conclusion: Personalized, color-coded and age-related risk communication about atherosclerosis had an effect on risk perception with an effect also after 3 years, whereas overall, no effect on efficacy beliefs was observed.

Place, publisher, year, edition, pages
Elsevier, 2024
Keywords
Atherosclerosis, Cardiovascular disease, Pictorial communication, Prevention, Response efficacy, Risk perception, Self efficacy, Vascular age
National Category
Psychology
Identifiers
urn:nbn:se:umu:diva-218586 (URN)10.1016/j.socscimed.2023.116530 (DOI)001166046000001 ()38169179 (PubMedID)2-s2.0-85181833982 (Scopus ID)
Funder
Region Västerbotten, ALFVLL-298001Region Västerbotten, AALFVLL- 643391Swedish Research Council, 521-2013-2708Swedish Research Council, 2016–01891Swedish Research Council, 2017–02246Swedish Heart Lung Foundation, 20150369Swedish Heart Lung Foundation, 20170481Swedish Society of MedicineThe Swedish Stroke AssociationSwedish Insurance SocietyVisare NorrThe Swedish Heart and Lung Association
Available from: 2023-12-21 Created: 2023-12-21 Last updated: 2024-04-26Bibliographically approved
Holmberg, H., Glader, E.-L., Näslund, U., Carlberg, B., Sönnerstam, E., Norberg, M. & Själander, A. (2024). Improved adherence to statin treatment and differences in results between men and women after pictorial risk communication: a sub-study of the VIPVIZA RCT. European Journal of Clinical Pharmacology
Open this publication in new window or tab >>Improved adherence to statin treatment and differences in results between men and women after pictorial risk communication: a sub-study of the VIPVIZA RCT
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2024 (English)In: European Journal of Clinical Pharmacology, ISSN 0031-6970, E-ISSN 1432-1041Article in journal (Refereed) Epub ahead of print
Abstract [en]

Background: People with intermediate CVD risk constitute most of the population. Within this group, the proportion of events is lower compared to the high-risk group, but they contribute with the largest absolute number of events. Atherosclerosis is a dynamic process and progression can be slowed or even reversed with medication and lifestyle changes, but adherence to prescribed treatment is crucial.

Aim: To investigate the long-term effects of interventions with pictorial risk communication of cardiovascular (CVD) risk on average adherence in a group of statin users. Compare response in adherence over time between men and women after intervention.

Methods: Participants on active statin treatment were followed up to 5 years after being randomly assigned to an intervention program aimed at raising CVD risk awareness among participants and their physicians. Merging prescribed medication databases with VIPVIZA study to study adherence over time. A moving average adherence was used to compare groups.

Results: Generally, the average adherence to statins among the 512 participants was high. Men had a higher average adherence over time, while women had a sharper increase in adherence in conjuncture with the intervention program.

Conclusions: Both men and women were receptive to pictorial information regarding CVD risk, but the intervention effect was more pronounced in women. Sex differences are important when considering risk communication strategies. Periodically repeating the intervention was beneficial for maintaining the intervention effect over time.

Trial registration: The VIPVIZA study is registered with ClinicalTrials.gov, May 8, 2013, number NCT01849575.

Place, publisher, year, edition, pages
Springer, 2024
Keywords
Atherosclerosis, Cardiovascular disease prevention, Cardiovascular risk, Pictorial information, Statin initiation, Statins
National Category
Public Health, Global Health, Social Medicine and Epidemiology Cardiac and Cardiovascular Systems
Identifiers
urn:nbn:se:umu:diva-224129 (URN)10.1007/s00228-024-03694-6 (DOI)001209527900001 ()38684558 (PubMedID)2-s2.0-85191700644 (Scopus ID)
Funder
Region Västerbotten, ALFVLL-298001Region Västerbotten, ALFVLL-643391Swedish Research Council, 521-2013-2708Swedish Research Council, 2016-01891Swedish Heart Lung Foundation, 20150369Swedish Heart Lung Foundation, 20170481Swedish Society of MedicineNorrländska HjärtfondenThe Swedish Stroke AssociationSwedish Social Insurance AgencyVisare NorrThe Swedish Heart and Lung Association
Available from: 2024-05-14 Created: 2024-05-14 Last updated: 2024-05-14
Hansén, N., Ljungberg, J., Bergdahl, I., Hultdin, J., Näslund, U., Johansson, B. & Söderberg, S. (2023). Adipokines are possible risk markers for aortic stenosis requiring surgery. Scandinavian Cardiovascular Journal, 57(1), Article ID 2247193.
Open this publication in new window or tab >>Adipokines are possible risk markers for aortic stenosis requiring surgery
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2023 (English)In: Scandinavian Cardiovascular Journal, ISSN 1401-7431, E-ISSN 1651-2006, Vol. 57, no 1, article id 2247193Article in journal (Refereed) Published
Abstract [en]

Objectives: Aortic stenosis (AS) is the most prevalent valvular heart disease among adults. The adipocyte-derived hormones, leptin and adiponectin, have profound metabolic actions. We examined whether these adipokines are independently associated with future aortic valve replacement (AVR).

Design: In this longitudinal case-control study, we identified 336 cases who had undergone AVR due to AS, and who had previously participated in population-based health surveys. Two referents were matched to each case and leptin and adiponectin concentrations were analysed from stored baseline survey samples. Uni- and multivariable logistic regression analyses were used to estimate the risk of future AVR. An additional cohort was identified for validation including 106 cases with AVR and 212 matched referents.

Results: Median age (interquartile range (IQR)) in years at survey was 59.9 (10.4) and at surgery 68.3 (12.7), and 48% were women. An elevated concentration of leptin was not associated with future AVR (odds ratio [95% confidence interval]) (1.10 [0.92–1.32]), although leptin was associated with a higher risk in patients with coronary artery disease (CAD) having more than 5 years between survey and AVR (1.41 [1.08–1.84]). Adiponectin was not associated with higher risk for future AVR (0.95 [0.82–1.11]), although after stratification for age, higher levels were associated with reduced risk for AVR in persons aged ≥60 years at surgery (0.79 [0.64–0.98]). In the validation study, leptin was associated with future AVR whereas adiponectin was not. None of the associations remained significant after adjustment for body mass index (BMI).

Conclusions: The adipokine leptin may promote the development of AS.

Place, publisher, year, edition, pages
Taylor & Francis, 2023
Keywords
adiponectin, Aortic stenosis, fat mass, leptin, prospective study, risk markers
National Category
Cardiac and Cardiovascular Systems
Identifiers
urn:nbn:se:umu:diva-214075 (URN)10.1080/14017431.2023.2247193 (DOI)001050266400001 ()37592808 (PubMedID)2-s2.0-85168287214 (Scopus ID)
Funder
Swedish Heart Lung Foundation, 20100635Swedish Heart Lung Foundation, 20120631Swedish Heart Lung Foundation, 20140799Swedish Heart Lung Foundation, 20130630Region Västerbotten, RV-967561Umeå University, 964731
Available from: 2023-09-04 Created: 2023-09-04 Last updated: 2023-09-04Bibliographically approved
Nordin, S., Norberg, M., Braf, I., Johansson, H., Lindahl, B., Lindvall, K., . . . Näslund, U. (2023). Associations between emotional support and cardiovascular risk factors and subclinical atherosclerosis in middle-age. Psychology and Health
Open this publication in new window or tab >>Associations between emotional support and cardiovascular risk factors and subclinical atherosclerosis in middle-age
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2023 (English)In: Psychology and Health, ISSN 0887-0446, E-ISSN 1476-8321Article in journal (Refereed) Epub ahead of print
Abstract [en]

Objective: To test the hypothesis of low emotional support being associated with lifestyle and biomedical cardiovascular disease (CVD) risk factors, estimated risk of CVD morbidity and mortality, and subclinical atherosclerosis in middle-aged healthy adults.

Methods and measures: Cross-sectional data were obtained from participants aged 40–60 years who had one or more conventional CVD risk factor. They underwent assessment based on questionnaires, clinical examination, blood sampling, and carotid ultrasound of plaque formation and carotid intima-media wall thickness (cIMT). Based on the Interview Schedule for Social Interaction, the participants were categorised as either low in emotional support (n = 884) or as a referent (n = 2570). Logistic regression analyses were conducted to study the associations.

Results: Logistic regression analyses showed that low emotional support was significantly associated with smoking, alcohol consumption and physical inactivity (OR = 1.53 − 1.94), estimated risk of CVD morbidity and mortality (OR = 1.56 − 1.68), and plaque formation (OR = 1.39). No significant associations were found regarding biomedical CVD risk factors or cIMT.

Conclusion: The findings suggest that low social support is associated with lifestyle CVD risk factors, estimated risk of CVD morbidity and mortality, and subclinical atherosclerosis in middle-aged healthy adults, encouraging causal evaluation with longitudinal data investigating an impact of emotional support on mechanisms underlying CVD.

Place, publisher, year, edition, pages
Routledge, 2023
Keywords
Cardiovascular disease, cardiovascular risk score, carotid artery plaque, carotid vascular ultrasound, social support
National Category
Public Health, Global Health, Social Medicine and Epidemiology Cardiac and Cardiovascular Systems
Identifiers
urn:nbn:se:umu:diva-217344 (URN)10.1080/08870446.2023.2286296 (DOI)37994844 (PubMedID)2-s2.0-85177567916 (Scopus ID)
Available from: 2023-12-01 Created: 2023-12-01 Last updated: 2023-12-01
Nyman, E., Liv, P., Wester, P., Näslund, U. & Grönlund, C. (2023). Carotid wall echogenicity at baseline associates with accelerated vascular aging in a middle-aged population. The International Journal of Cardiovascular Imaging, 39(3), 575-583
Open this publication in new window or tab >>Carotid wall echogenicity at baseline associates with accelerated vascular aging in a middle-aged population
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2023 (English)In: The International Journal of Cardiovascular Imaging, ISSN 1569-5794, E-ISSN 1875-8312, Vol. 39, no 3, p. 575-583Article in journal (Refereed) Published
Abstract [en]

Ultrasonic echolucent carotid intima-media (IM) complex and accelerated progression of carotid intima mediathickness (cIMT) have both separately been shown to predict future cardiovascular events. The aim of this studywas to evaluate if the echogenicity of the IM-complex is associated with the 3-year progression of cIMT. B-modeultrasound images captured at baseline and 3-year follow-up in the ‘Visualization of asymptomatic atherosclerotic disease for optimum cardiovascular prevention’ (VIPVIZA) trial were included (n: 3154). The bilateral mean cIMT and IM-echogenicity by greyscale median (GSM) were measured in the common carotid artery. Associations between IM-GSM at baseline and the 3-year cIMT progression were investigated using linear regression models for the whole population and stratified by sex, age and VIPVIZA study group (intervention versus control). In addition, adjusted analyses for confounding factors were performed. Unadjusted analysis showed that decreased IM-GSM at baseline was associated with increased progression of cIMT (p < 0.001). Stratified by age, the association was significant among 40 (p < 0.001) and 60 years old (p < 0.001). The association was statistically significant in both sexes and on comparison of VIPVIZA study subgroups. Adjustments for confounding factors did not alter the estimated relationship between IM-GSM and cIMT progression. Echolucent carotid intima media at baseline associates with increased 3-year cIMT progression among an asymptomatic, middle-aged population. Echogenicity of the intima media may identify individuals at risk for accelerated vascular aging.

Place, publisher, year, edition, pages
Springer Science+Business Media B.V., 2023
Keywords
Asymptomatic, Atherosclerosis, Carotid intima media, Echogenicity, Ultrasound
National Category
Cardiac and Cardiovascular Systems
Identifiers
urn:nbn:se:umu:diva-204476 (URN)10.1007/s10554-022-02760-3 (DOI)000919023200002 ()36680684 (PubMedID)2-s2.0-85146659539 (Scopus ID)
Funder
Region Västerbotten, ALFVLL-298001Region Västerbotten, ALFVLL643391Swedish Research Council, 521-2013-2708Swedish Research Council, 2016−01891Swedish Heart Lung Foundation, 20150369Swedish Heart Lung Foundation, 20170481Swedish Society of MedicineVisare Norr
Available from: 2023-02-17 Created: 2023-02-17 Last updated: 2023-09-05Bibliographically approved
Salvador, D., Liv, P., Norberg, M., Pahud de Mortanges, A., Saner, H., Glisic, M., . . . Näslund, U. (2023). Changes in fasting plasma glucose and subclinical atherosclerosis: a cohort study from VIPVIZA trial. Atherosclerosis, Article ID 117326.
Open this publication in new window or tab >>Changes in fasting plasma glucose and subclinical atherosclerosis: a cohort study from VIPVIZA trial
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2023 (English)In: Atherosclerosis, ISSN 0021-9150, E-ISSN 1879-1484, article id 117326Article in journal (Refereed) In press
Abstract [en]

Background and aims: Studies on the influence of fasting plasma glucose (FPG) on the development of carotid plaque (CP) and intima media thickness (CIMT) mainly focused on single FPG measures. We investigated whether changes in FPG (ΔFPG) are associated with incident CP and CIMT change (ΔCIMT) over time.

Methods: Analyses were based on information from 1896 participants from the VIPVIZA trial (Visualization of asymptomatic atherosclerotic disease for optimum cardiovascular prevention), with baseline and 3-year follow-up data on FPG, ultrasonographic CP (none or ≥1 lesion/s) and CIMT assessments. We studied the association between baseline FPG (prior to intervention) or 3-year ΔFPG (mmol/L) and incident CP (logistic regression) or ΔCIMT (linear regression). Analyses were adjusted for multiple potential confounders.

Results: 1896 and 873 individuals, respectively, were included in the analysis on incident CP and ΔCIMT. Participants were 60 years old at baseline and 61% and 54% were females, in the CP and CIMT analyses, respectively. Every mmol/L increase in FPG was associated with an increased odds of incident CP (odds ratio: 1.42, 95% confidence interval [CI]: 1.17, 1.73), but there was no association with ΔCIMT (mean difference: 0.002 mm, 95% CI: −0.003, 0.008) after 3 years. Baseline FPG was not associated with incident CP nor ΔCIMT progression.

Conclusions: In middle-aged individuals with low to moderate risk for cardiovascular diseases, 3-year ΔFPG was positively associated with the risk of incident CP, but not with ΔCIMT. Single measures of FPG may not be sufficient in estimating cardiovascular risk among individuals with low to moderate risk.

Place, publisher, year, edition, pages
Elsevier, 2023
Keywords
Carotid intima media thickness, Carotid plaque, Fasting plasma glucose, Prevention, Subclinical atherosclerosis
National Category
Cardiac and Cardiovascular Systems
Identifiers
urn:nbn:se:umu:diva-216637 (URN)10.1016/j.atherosclerosis.2023.117326 (DOI)37932189 (PubMedID)2-s2.0-85175522942 (Scopus ID)
Funder
EU, Horizon 2020, 801076
Available from: 2023-11-16 Created: 2023-11-16 Last updated: 2024-04-26
Yu Chen, H., Dina, C., Small, A. M., Shaffer, C. M., Levinson, R. T., Helgadóttir, A., . . . Thanassoulis, G. (2023). Dyslipidemia, inflammation, calcification, and adiposity in aortic stenosis: a genome-wide study. European Heart Journal, 44(21), 1927-1939
Open this publication in new window or tab >>Dyslipidemia, inflammation, calcification, and adiposity in aortic stenosis: a genome-wide study
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2023 (English)In: European Heart Journal, ISSN 0195-668X, E-ISSN 1522-9645, Vol. 44, no 21, p. 1927-1939Article in journal (Refereed) Published
Abstract [en]

AIMS: Although highly heritable, the genetic etiology of calcific aortic stenosis (AS) remains incompletely understood. The aim of this study was to discover novel genetic contributors to AS and to integrate functional, expression, and cross-phenotype data to identify mechanisms of AS. METHODS AND RESULTS: A genome-wide meta-analysis of 11.6 million variants in 10 cohorts involving 653 867 European ancestry participants (13 765 cases) was performed. Seventeen loci were associated with AS at P ≤ 5 × 10-8, of which 15 replicated in an independent cohort of 90 828 participants (7111 cases), including CELSR2-SORT1, NLRP6, and SMC2. A genetic risk score comprised of the index variants was associated with AS [odds ratio (OR) per standard deviation, 1.31; 95% confidence interval (CI), 1.26-1.35; P = 2.7 × 10-51] and aortic valve calcium (OR per standard deviation, 1.22; 95% CI, 1.08-1.37; P = 1.4 × 10-3), after adjustment for known risk factors. A phenome-wide association study indicated multiple associations with coronary artery disease, apolipoprotein B, and triglycerides. Mendelian randomization supported a causal role for apolipoprotein B-containing lipoprotein particles in AS (OR per g/L of apolipoprotein B, 3.85; 95% CI, 2.90-5.12; P = 2.1 × 10-20) and replicated previous findings of causality for lipoprotein(a) (OR per natural logarithm, 1.20; 95% CI, 1.17-1.23; P = 4.8 × 10-73) and body mass index (OR per kg/m2, 1.07; 95% CI, 1.05-1.9; P = 1.9 × 10-12). Colocalization analyses using the GTEx database identified a role for differential expression of the genes LPA, SORT1, ACTR2, NOTCH4, IL6R, and FADS. CONCLUSION: Dyslipidemia, inflammation, calcification, and adiposity play important roles in the etiology of AS, implicating novel treatments and prevention strategies.

Place, publisher, year, edition, pages
Oxford University Press, 2023
Keywords
Aortic stenosis, Gene expression, Genetic risk score, Genome-wide association study, Mendelian randomization, Phenome-wide association study
National Category
Cardiac and Cardiovascular Systems Medical Genetics
Identifiers
urn:nbn:se:umu:diva-209555 (URN)10.1093/eurheartj/ehad142 (DOI)000989753300001 ()37038246 (PubMedID)2-s2.0-85160838840 (Scopus ID)
Funder
Swedish Heart Lung Foundation, 20140799Swedish Heart Lung Foundation, 20120631Swedish Heart Lung Foundation, 20100635Region Västerbotten, VLL-548791Swedish Heart Lung Foundation, 2016-0134Swedish Heart Lung Foundation, 2016-0315Swedish Heart Lung Foundation, 2019-0526Swedish Research Council, 2017-02554Knut and Alice Wallenberg FoundationSwedish Research Council, 349-2006-237Swedish Foundation for Strategic Research, IRC15-0067NIH (National Institutes of Health), R01 HL128550NordForsk, 90580
Available from: 2023-06-12 Created: 2023-06-12 Last updated: 2023-09-05Bibliographically approved
Rohlén, R., Jiang, B., Nyman, E., Wester, P., Näslund, U. & Grönlund, C. (2023). Interframe Echo Intensity Variation of Subregions and Whole Plaque in Two-Dimensional Carotid Ultrasonography: Simulations and in Vivo Observations. Journal of ultrasound in medicine, 42(5), 1033-1046
Open this publication in new window or tab >>Interframe Echo Intensity Variation of Subregions and Whole Plaque in Two-Dimensional Carotid Ultrasonography: Simulations and in Vivo Observations
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2023 (English)In: Journal of ultrasound in medicine, ISSN 0278-4297, E-ISSN 1550-9613, Vol. 42, no 5, p. 1033-1046Article in journal (Refereed) Published
Abstract [en]

Objectives: The risk of cardiovascular disease is associated with the echo intensity of carotid plaques in ultrasound images and their cardiac cycle-induced intensity variations. In this study, we aimed to 1) explore the underlying origin of echo intensity variations by using simulations and 2) evaluate the association between the two-dimensional (2D) spatial distribution of these echo intensity variations and plaque vulnerability.

Methods: First, we analyzed how out-of-plane motion and compression of simulated scattering spheres of different sizes affect the ultrasound echo intensity. Next, we propose a method to analyze the features of the 2D spatial distribution of interframe plaque echo intensity in carotid ultrasound image sequences and explore their associations with plaque vulnerability in experimental data.

Results: The simulations showed that the magnitude of echo intensity changes was similar for both the out-of-plane motion and compression, but for scattering objects smaller than 1 mm radius, the out-of-plane motion dominated. In experimental data, maps of the 2D spatial distribution of the echo intensity variations had a low correlation with standard B-mode echo intensity distribution, indicating complementary information on plaque tissue composition. In addition, we found the existence of ∼1 mm diameter subregions with pronounced echo intensity variations associated with plaque vulnerability.

Conclusions: The results indicate that out-of-plane motion contributes to intra-plaque regions of high echo intensity variation. The 2D echo intensity variation maps may provide complementary information for assessing plaque composition and vulnerability. Further studies are needed to verify this method's role in identifying vulnerable plaques and predicting cardiovascular disease risk.

Place, publisher, year, edition, pages
John Wiley & Sons, 2023
National Category
Cardiac and Cardiovascular Systems Medical Engineering
Identifiers
urn:nbn:se:umu:diva-200460 (URN)10.1002/jum.16114 (DOI)000870331800001 ()36264181 (PubMedID)2-s2.0-85140218004 (Scopus ID)
Funder
Swedish Research Council, 2015-04461Västerbotten County Council, VLL-581211
Available from: 2022-10-20 Created: 2022-10-20 Last updated: 2023-07-13Bibliographically approved
Bengtsson, A., Nyman, E., Grönlund, C., Wester, P., Näslund, U., Fhärm, E. & Norberg, M. (2023). Multi-view carotid ultrasound is stronger associated with cardiovascular risk factors than presence of plaque or single carotid intima media thickness measurements in subclinical atherosclerosis. The International Journal of Cardiovascular Imaging, 39(8), 1461-1471
Open this publication in new window or tab >>Multi-view carotid ultrasound is stronger associated with cardiovascular risk factors than presence of plaque or single carotid intima media thickness measurements in subclinical atherosclerosis
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2023 (English)In: The International Journal of Cardiovascular Imaging, ISSN 1569-5794, E-ISSN 1875-8312, Vol. 39, no 8, p. 1461-1471Article in journal (Refereed) Published
Abstract [en]

We aimed to explore the prevalence of atherosclerosis by using multi-view ultrasound examination of the carotid arteries and its association with clinical risk factors in a middle-aged population at low to intermediate risk of cardiovascular disease (CVD). Carotid vascular ultrasound was performed in 3532 participants in the VIPVIZA trial. Mean and maximal carotid intima media thickness (cIMT) at prespecified angles and plaque presence were examined on the left and right side. Associations between CVD risk factors and ultrasound variables were quantified by partial least squares (PLS) regression. A combined ultrasound variable was computed using weights of the first PLS component. Associations between CVD risk factors and the combined multi-view ultrasound variable, single cIMT and plaque measurements, respectively, were determined using linear regression modelling. The participants’ mean age was 55.7 years and 52.9% were women. Plaque prevalence was 51.1% in men and 39.0% in women. cIMT was higher in men than in women and in the left compared with the right carotid artery. The strongest association of CVD risk factors was observed with the combined multi-view ultrasound variable (R2 = 24%), compared with single cIMT variables (R2 = 14–18%) and plaque presence (R2 = 15%). The pattern was similar in both sexes. The association with CVD risk factors and the combined ultrasound variable was stronger in 40-year olds (R2 = 22%) compared with 50- or 60-year olds (R = 12%). CVD risk factors are stronger associated with a combined ultrasound variable than plaque presence or single cIMT measures suggesting that carotid multi-view ultrasonography better captures the focality of early atherosclerosis. Clinical Trial Registration: ClinicalTrials.gov, number NCT01849575. May 8, 2013.

Place, publisher, year, edition, pages
Springer Nature, 2023
Keywords
Atherosclerosis, Cardiovascular disease, Carotid intima media thickness, Carotid plaque, Carotid ultrasound
National Category
Cardiac and Cardiovascular Systems
Identifiers
urn:nbn:se:umu:diva-209575 (URN)10.1007/s10554-023-02868-0 (DOI)000998250600001 ()37249653 (PubMedID)2-s2.0-85160655052 (Scopus ID)
Funder
Visare NorrNorrbotten County CouncilUmeå UniversityThe Swedish Medical Association, SLS-405351The Swedish Medical Association, SLS-503111Swedish Research Council, 521-2013-2708
Available from: 2023-06-12 Created: 2023-06-12 Last updated: 2023-09-20Bibliographically approved
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