The Conversations in Science Series brings together UW-Madison researchers and Dane County teachers in order to foster significant connections. Now in its 10th year, the Series is designed to provide personal enrichment to teachers in a wide range of areas related to science, technology and society, and to enable researchers and educators to share their expertise with the Dane County community.

ABOUT THE CONVERSATION

Since heart and vascular diseases are the leading causes of death in the United States, primary prevention of cardiovascular events is a health care priority. A key challenge to primary prevention efforts is identifying individuals who would be candidates for more intensive medical interventions. Measurement of carotid intima-media thickness (CIMT) with B-mode ultrasound is a noninvasive and highly reproducible technique for quantifying atherosclerotic burden. It is a well-validated research tool that increasingly is being used as a clinical tool. This conversation will review the current state of cardiovascular disease risk prediction and its limitations. It will focus on the use of carotid ultrasound to measure CIMT as a potential tool to help improve risk prediction. This talk will review the scientific and epidemiological evidence supporting use of this test, as well as its strengths, limitations, and future research directions.

ABOUT THE SPEAKER

James H. Stein, MD is a Professor of Medicine in the Division of Cardiovascular Medicine at the University of Wisconsin School of Medicine and Public Health in Madison, Wisconsin. He is Director of the Preventive Cardiology Program and Director of the Vascular Health Screening Program at the University of Wisconsin Hospital and Clinics. Dr. Stein also is the Director of the University of Wisconsin Atherosclerosis Imaging Research Program. Dr. Stein received his baccalaureate degree with honors from the University of Wisconsin. He received his Doctor of Medicine (cum laude) degree from the Yale University School of Medicine in New Haven, Connecticut. His Internship and Residency in Internal Medicine were at the University of Chicago Medical Center in Illinois. He completed a Cardiology Fellowship at Rush-Presbyterian-St. Luke's Medical Center in Chicago, Illinois. Dr. Stein’s research interests include ultrasound assessment of atherosclerosis, endothelial function, and clinical trials in preventive cardiology. Specific interests include the detection and characterization of subclinical atherosclerosis in patients with sleep apnea, tobacco use, and human immunodeficiency virus, and the use of carotid intima-media thickness measurements for determination of “vascular age” and cardiovascular risk prediction.

SUGGESTED READING

1. Stein JH, Carotid intima-media thickness and vascular age: You are only as old as your arteries look. Journal of the American Society of Echocardiography 2004; 17:686-689.

2. Stein JH, Fraizer MC, Aeschlimann SE, Nelson-Worel J, McBride PE, Douglas PS. Vascular age: Integrating carotid intima-media thickness measurements with global coronary risk assessment. Clinical Cardiology 2004; 27:388-392.

3. Gepner AD, Keevil JG, Wyman RA, Aeschlimann SE, Korcarz CE, Busse KL, Stein JH. Use of carotid intima-media thickness and "vascular age" to modify cardiovascular risk prediction. Journal of the American Society of Echocardiography 2006; 19:1170-1174.

4. Gepner AD, Korcarz CE, Aeschlimann SA, LeCaire TJ, Palta M, Tzou WS, Stein JH. Validation of a Carotid Intima-Media Thickness Border Detection Program for Use in an Office Setting. Journal of the American Society of Echocardiography 2006; 19:223-228.

5. Stein JH, Korcarz CE, Hurst RT, Lonn E, Kendall CB, Mohler ER, Najjar S, Rembold CM, Post WS. Use of carotid ultrasound to identify subclinical vascular disease and evaluate cardiovascular disease risk: A consensus statement from the American Society of Echocardiography Carotid Intima-Media Thickness Task Force. Journal of the American Society of Echocardiography 2008; 21:93-111.

6. Korcarz CE, Hirsch AT, Bruce C, DeCara JM, Mohler ER, Pogue B, Postley J, Tzou WS, Stein JH. Carotid intima-media thickness testing by non-sonographer clinicians: The Office Practice Assessment of Carotid Atherosclerosis (OPACA) Study. Journal of the American Society of Echocardiography 2008; 21:117-122.

7. Korcarz CE, DeCara JM, Hirsch AT, Pogue B, Postley J, Tzou WS, Stein JH. Ultrasound detection of increased carotid intima-media thickness and carotid plaque in an office practice setting: Does it affect physician behavior or patient motivation? Journal of the American Society of Echocardiography 2008; 21:1156-1161.