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( Intima-media thickness)
Intima-media thickness (IMT), also called intimal medial thickness, is a measurement of the thickness of artery walls, usually by external ultrasound, occasionally by internal, invasive ultrasound catheters, see IVUS, to both detect the presence and to track the progression of atherosclerotic disease in humans. IMT has increasingly been used in medical research since the mid 1990's to track changes in arterial walls and is occasionally used in clinical medicine by more progressive clinicians. Historically, since the 1950's, focus was initially placed on detection and progression of the atherosclerotic process by its late affects on the lumens of arterial blood vessels, either narrowing or enlargement. This led to the still widely held beliefs that if the lumen looked OK, then little to no atherosclerotic disease was presumed to be present. However, the atherosclerosis process occurs within the walls of blood vessels, not the lumen. Starting primarily in the 1980s, especially with improvements in both CAT scanner, see EBT, and ultrasound technology, see IVUS, plus better understanding of the atherosclerotic process from both basic science and clinical research efforts, attention started slowly and increasingly shifting to detecting and tracking arterial disease at earlier stages, well before changes to the lumen of the artery either occur or become detectable by any technology. Since the 1990's, both small clinical and several larger scale pharmaceutical trials have used CIMT (carotid IMT) as a surrogate endpoint for evaluating the regression and/or progression of atherosclerotic cardiovascular disease. Many studies have documented the relation between the carotid intima-media thickness and the presence and severity of atherosclerosis. In 2003 the European Society of Hypertension-European Society of Cardiology recommended the use of IMT measurements in high-risk patients to help identify target organ damage not revealed by other exams such as the electrocardiogram.
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