The prediction of high echogenicity of intimal area in carotid artery for the plaque burden of culprit lesion in coronary artery disease

Background and Objectives: The intima-media thickness (IMT) of the common carotid artery has been widely used as a good index of atherosclerosis. The aim of this study was to test the correlation between the thickness of the high echogenicity intimal area (HELIT) on carotid ultrasound and the plaque burden of the culprit lesion on coronary intravascular ultrasound (IVUS). Subjects and Methods: In 33 patients (M: F=20: 13, mean age 63 ± 8 yrs) that underwent coronary angiogram, the HELIT and IMT from carotid ultrasound were compared with the plaque burden of the culprit vessel on IVUS. The high echogenic layer of the intimai area (HELIA) on carotid ultrasound was defined as a thickened echogenic superficial layer at the far wall of the common carotid artery using 15 MHz linear array transducer. The plaque burden was defined as the maximal percent plaque area of the culprit lesion on IVUS. The HELIT and IMT ration was defined as the percent ratio of HELIT on IMT. Results: The mean HELIT, carotid IMT, ratio of HELIT/IMT and maximal percent plaque area of the culprit lesion were 0.27 ± 0.03 mm, 0.85 + 0.22 mm, 0.33 ± 0.07 and 68.43 ± 11%, respectively. The HELIT was closely related to the maximal percent plaque area on IVUS (r=0.34, p<0.05), but not to the other IVUS parameters or risk factors of CAD. Conclusion: Our data suggest that the high echogenic layer of the intimal area on carotid ultrasound is predictive of the plaque burden in the culprit vessel.