Nonlinear model for the carotid artery disease 10-year risk prediction by fusing conventional cardiovascular factors to carotid ultrasound image phenotypes: A Japanese diabetes cohort study

Echocardiography. 2019 Feb;36(2):345-361. doi: 10.1111/echo.14242. Epub 2019 Jan 9.

Abstract

Motivation: This study presents a novel nonlinear model which can predict 10-year carotid ultrasound image-based phenotypes by fusing nine traditional cardiovascular risk factors (ethnicity, gender, age, artery type, body mass index, hemoglobin A1c, hypertension, low-density lipoprotein, and smoking) with five types of carotid automated image phenotypes (three types of carotid intima-media thickness (IMT), wall variability, and total plaque area).

Methodology: Two-step process was adapted: First, five baseline carotid image-based phenotypes were automatically measured using AtheroEdge (AtheroPoint , CA, USA) system by two operators (novice and experienced) and an expert. Second, based on the annual progression rates of cIMT due to nine traditional cardiovascular risk factors, a novel nonlinear model was adapted for 10-year predictions of carotid phenotypes.

Results: Institute review board (IRB) approved 204 Japanese patients' left/right common carotid artery (407 ultrasound scans) was collected with a mean age of 69 ± 11 years. Age and hemoglobin were reported to have a high influence on the 10-year carotid phenotypes. Mean correlation coefficient (CC) between 10-year carotid image-based phenotype and age was improved by 39.35% in males and 25.38% in females. The area under the curves for the 10-year measurements of five phenotypes IMTave10yr , IMTmax10yr , IMTmin10yr , IMTV10yr , and TPA10yr were 0.96, 0.94, 0.90, 1.0, and 1.0. Inter-operator variability between two operators showed significant CC (P < 0.0001).

Conclusions: A nonlinear model was developed and validated by fusing nine conventional CV risk factors with current carotid image-based phenotypes for predicting the 10-year carotid ultrasound image-based phenotypes which may be used risk assessment.

Keywords: 10-year risk prediction; atherosclerosis; carotid; intima-media thickness; nonlinear modeling; stroke; total plaque area; traditional cardiovascular risk; ultrasound.

MeSH terms

  • Aged
  • Carotid Arteries / diagnostic imaging
  • Carotid Arteries / pathology
  • Carotid Artery Diseases / diagnostic imaging*
  • Carotid Artery Diseases / epidemiology*
  • Carotid Artery Diseases / pathology
  • Cohort Studies
  • Diabetes Mellitus*
  • Female
  • Humans
  • Japan / epidemiology
  • Male
  • Middle Aged
  • Predictive Value of Tests
  • Risk Assessment
  • Ultrasonography / methods