A/L Ramanathan, Prahalad
(2015)
The relationship between sonographic parameters of brachial artery and smoking.
Masters thesis, Universiti Sains Malaysia.
Abstract
Background
Anatomical changes in brachial artery like thickening of initima-media thickness (IMT)
has shown to significantly associated with progression of atherosclerosis. This changes
will ultimately lead to manifestation of cardiac vascular disease like coronary artery
disease and stroke, which causes 17.3 millions of death cases worldwide, in both
developed and developing countries. The number of death cases will continue to
increase if preventive measure is not taken to control the risk factors associated with the
atherosclerosis. The high-resolution sonography has shown to be a non-invasive and
radiation-free clinical tools in measuring IMT value of artery, which provide insight to
the progression of atherosclerosis in high risk group including smokers.
Aim and Objective
The present study aimed to determine the association between sonography parameters
of the brachial artery and smoking.
Method
High resolution ultrasonography was used to examine the brachial artery among smoker
and non-smokers, which recruited from the staff of Hospital Universiti Sains Malaysia.
The brachial artery is scanned in the antecubital fossa in a longitudinal fashion. Optimal
brachial artery images were obtained at about 5-10 cm above the antecubital crease.
This location was marked, and all subsequent images were obtained at the same
location. The IMT at the far wall is measured directly as the distance between the
lumen-intima and media-adventitia border at the distal portions of the brachial (5-10cm
above elbow). Measurement of PSV and RI are taken. Doppler angle is keep at <60º.
Result
There were 45 staff of Hospital Universiti Sains Malaysia (HUSM) volunteered to
participate in this study. Among these participants, 20 (44.4%) of them were smokers
while 25 (55.6%) of them were non-smokers. The mean of the intimal media thickness
is 0.36±0.01 mm for smokers and 0.30±0.01 mm for non-smokers. The mean of the
peak systolic velocity is 57.50±14.79 cm/sec for smokers and 48.94±5.19 cm/sec for
non-smokers. The mean of the resistive index is 0.90±0.03 for smokers and 0.85±0.13
for non-smokers. There is significant difference of brachial artery intimal media
thickness and resistive index between smokers and non-smokers (p<0.01), but not the
peak systolic value. Among the two significant variables, only intimal media thickness
and duration of smoking showed significant correlation and regression (r=0.754;
r2=0.568, p<0.01).
Conclusion
The present study revealed significant thickening of IMT in smokers compared to nonsmokers
among HUSM staff. This suggested the application of high resolution
ultrasonography in screening of IMT among smokers, which is consider as high risk
group for atherosclerosis.
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