One, two and three-dimensional ultrasound measurements of carotid atherosclerosis before and after cardiac rehabilitation: Preliminary results of a randomized controlled trial

Abstract

Background: It is still not known how patients who are post-transient ischemic attack (TIA) or post-stroke might benefit from prospectively planned comprehensive cardiac rehabilitation (CCR). In this pilot evaluation of a larger ongoing randomized-controlled-trial, we evaluated ultrasound (US) measurements of carotid atherosclerosis in subjects following TIA or mild non-disabling stroke and their relationship with risk factors before and after 6-months of CCR. Methods. Carotid ultrasound (US) measurements of one-dimensional intima-media-thickness (IMT), two-dimensional total-plaque-area (TPA), three-dimensional total-plaque-volume (TPV) and vessel-wall-volume (VWV) were acquired before and after 6-months CCR for 39 subjects who had previously experienced a TIA and provided written informed consent to participate in this randomized controlled trial. We maintained blinding for this ongoing study by representing treatment and control groups as A or B, although we did not identify which of A or B was treatment or control. Carotid IMT, TPA, TPV and VWV were measured before and after CCR as were changes in body mass index (BMI), total cholesterol (TC), high-density lipoprotein (HDL), low-density lipoprotein (LDL), triglycerides (TG), systolic blood pressure (SBP) and diastolic blood pressure (DBP). Results: There were no significant differences in US measurements or risk factors between groups A and B. There was no significant change in carotid ultrasound measurements for group A (IMT, p =.728; TPA, p =.629; TPV, p =.674; VWV, p =.507) or B (IMT, p =.054; TPA, p =.567; TPV, p =.773; VWV, p =.431) at the end of CCR. There were significant but weak-to-moderate correlations between IMT and VWV (r = 0.25, p =.01), IMT and TPV (r = 0.21, p =.01), TPV and TPA (r = 0.60, p