LAUSR

Objective: Cardiovascular diseases are associated with an increase in intima-media thickness (IMT). However, the techniques used to measure IMT have limitations. A semi-automatic device called UNEX has been developed, which overcomes the limitation of classic systems (in particular the investigator-dependency of conventional, “hand-held’’ measurements). The purpose of this study was to measure the intima-media thickness of the brachial artery (bIMT) with the UNEX device in patients with and without congestive heart failure. Design and method: The UNEX device is comprised of a 7.5-MHz, H-shaped linear array transducer and a novel stereotactic probe-holding device (UNEX EF 18G; UNEX Co., Nagoya, Japan). Another advantage of this device is the continuous recording of B-mode images and A-mode waves of the brachial artery. Measurement of bIMT was automatically performed on A-mode images of the far wall of the brachial artery. The analysis system automatically detects the measurement point where an image was clearly obtained. The average of mean measurement values obtained from 10 cardiac cycles was defined as bIMT. In a first set of clinical studies, we measured bIMT in patients with reduced left ventricular ejection fraction (HFrEF) and in patients without heart failure. Results: Patients with HFrEF (n = 85, ejection fraction: 38.3 ± 8.4 %, NT-pro-BNP: 713 ± 714.7 pg/ml) compared to patients without heart failure (n = 63) were older (66.4 ± 9.2 vs. 53.8 ± 12.6 years, p < 0.001), with more male subjects (67 vs. 40, p = 0.039). bIMT was higher in patients with HFrEF compared to the other group (0.295 ± 0.083 vs. 0.249 ± 0.083 mm, p < 0.001). After adjustment for age, gender and other cardiovascular risk factors, the result remained significant (p = 0.032). Conclusions: Our study demonstrate that IMT of large muscular arteries can be automatically (investigator independently) measured. Our data indicate an increased vascular remodeling in patients with HFrEF independent of other confounders.