Feasibility and reliability of carotid intima–media thickness measurements in nonsedated infants

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Carotid intima–media thickness (CIMT) is a surrogate marker for atherosclerosis. It is increased in adolescents and young adults at risk for future cardiovascular disease. However, it remains unclear if it can be considered as a surrogate marker for atherosclerosis in infancy as very few studies have been performed in infants.


Our objective was to assess the feasibility and interobserver reproducibility of CIMT measurement in nonsedated infants.


We measured CIMT in 81 infants less than 1 year of age. Repeated measurements were obtained by a second observer in 24 children. The analysis was performed with semiautomated edge detection software. Measurements with over 95% edge detection over a length of 1 cm were considered as valid. We further compared the measurements using the semiautomated method with measurements using the manual electronic caliper method in a subgroup of 10 infants.


Carotid ultrasound recordings and intima–media thickness measurements were obtained in 79% of infants (n = 64). Mean CIMT of the 64 infants measured by the first observer was 0.44 mm (SD: 0.04). In the 24 participants with measurements by two observers, the mean interobserver difference was 0.001 mm (SD: 0.026). The interobserver coefficient of variation was 5.9%. CIMT measurements obtained with the manual method (mean: 0.35; range: 0.29–0.39) were slightly lower than measurements obtained with the semiautomated method (mean: 0.38; range: 0.32–0.44). Measurements with both methods were highly correlated (r: 0.87).


Measurement of CIMT in nonsedated infants less than 1 year of age is feasible in the majority of infants with good interobserver variability.

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