The Carotid Intima-Media Thickness (CIMT) test is a sophisticated ultrasound that measures the thickness of the inner layers of the carotid artery. The carotid artery is easy to access, and its intima-media thickness has 90% correlation with the arteries of the heart and the rest of the body. Traditional artery scans, such as the Duplex Scan look for advanced plaque in the lumen of the artery. CIMT precisely measures the intima-media layer where plaque first develops.
The CIMT measurement indicates the presence or absence of atherosclerotic disease, and the degree of atherosclerotic burden: the greater the CIMT, the greater the risk of heart attack or stroke. Most importantly, the CIMT test identifies cardiovascular risk early, when the condition is most treatable, and YEARS before it can be identified by traditional carotid artery scans. The CIMT test:
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Later that year, this 50 year-old marathon runner had a CIMT test as a part of a research study at the University of Southern California. Although family history of early heart disease was his only significant risk factor, the thickness of the fatty cholesterol plaque in his carotid artery was greater than that of the average 80 year-old, and his risk of heart attack or stroke was 591% greater than that of other men his age. With aggressive treatment, he was able to reduce his CIMT by 50% over the next ten years.
Most of the men in his family died of a heart attack before age 50 without any prior symptoms. As a non-smoker who enjoyed a lifetime of fitness, he was determined to do better. In 1996, a few weeks before his 50th birthday, his Berkley Heart Lab Comprehensive Evaluation was completely normal. Results included normal EKG, cholesterol, blood pressure, cardio CRP, nuclear stress test, coronary artery calcium score, and traditional carotid artery scan.
The CIMT test is a quick, painless, noninvasive, ultrasound that does not involve injections, pills, or radiation. The test has two parts. There are no special test requirements, and the patient is not required to disrobe. A Registered Vascular Technologist applies conducting gel to the skin over the neck, and then uses a small hand-held transducer to take sonographic images of the carotid arteries. The procedure is well tolerated and it takes about 15 minutes. ArterioVisionTM, a sophisticated computer program is then used to measure the intima-media thickness. Results are generally available in 1 week.
The CIMT Test Report is a technical document, but it also includes vital information in easily understandable terms. The CIMT Percentile compares your carotid artery intima-media thickness measurement to thousands of individuals of the same age and sex to show where your results fall statistically. Arterial Age compares your current age to the average age of people with your CIMT. Here’s an example.
The line graph shows information for a 50 year old woman with a CIMT of 0.790mm. Notice that she’s in the 84th percentile of 50 year old women. This means that 84% of 50 year old women have a CIMT that is better, and 16% have a CIMT that is worse. The bar chart shows her Arterial Age by comparing her age to the average age of women with a CIMT of 0.790mm. In fact, our 50 year old woman’s Arterial Age is 72.
View a sample CIMT Report.
CIMT testing is most effective when used in conjunction with traditional risk factor assessment methods. People who are believed to be at intermediate risk by Framingham Risk Assessment are ideal candidates. The AHA recommends CIMT for everyone over 45 years of age, and for people younger than 45 with multiple risk factors. As shown in the case study, CIMT testing can also be used to monitor the progression or regression of heart disease by tracking the thickening or thinning of the intima-media and the degree of plaque involvement. Leading physicians across the country use CIMT to assess initial risk, and to monitor the affect of prescribed treatment over time. CIMT testing adds incremental information to traditional risk factor methods and helps to create a more complete picture of true cardiovascular risk. CIMT is an independent risk factor even in the absence of any other identifiable risk factors.
Aggressive treatment with lifestyle modifications and medication can halt or even reverse the progression of atherosclerotic plaque, reducing the risk of heart attack and stroke as much as 40%. Remember...
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