Ultrasound scans of the distal common carotid artery (right/left) were obtained from 120 patients with cardiovascular risk factors and 30 healthy controls. The C-IMT was measured on the far wall, 1 cm above the bifurcation. The dataset was analysed by two operators both automatically and manually. The first operator repeated the analysis twice. The agreement between automatic and manual measurements was evaluated by Bland-Altman plots: a bias of -0.020mm and an interval of agreement of 0.027mm

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... ere obtained. Intra-observer variability was computed on the repeated measurements of the first operator. Bias was not significantly different from zero for both manual and automatic measurements, whereas the interval of agreement was 0.077mm in manual analysis and 0.012mm in automatic analysis. Coefficients of variation of 2.8% and 0.4% were obtained, respectively. Inter-observer variability showed a little bias (-0.032mm) only for manual analysis, whereas the interval of agreement was 0.075mm in manual analysis and 0.021mm in automatic analysis with coefficients of variation of 4.5% and 0.6%, respectively. In conclusion, the new real-time automatic system represents a more feasible and reproducible method than the manual approach when used to estimate C-IMT in clinical studies and practice. Purpose: Metabolic syndrome is related to increased inflammatory status. Arterial stiffness is an important determinant of cardiovascular performance and a predictor of the corresponding risk. The aim of the present study was to investigate the association of low-grade inflammation with arterial stiffness and wave reflections in hypertensive patients with metabolic syndrome. Methods: We studied 106 consecutive patients with never treated essential hypertension and metabolic syndrome, defined according to the Adult Treatment Panel III criteria. Arterial stiffness was assessed by measuring carotid-femoral (PWVc-f) and carotid-radial pulse wave velocity (PWVc-r). Heart rate corrected augmentation index (AIx 75 ) was studied as a measure of wave reflections and arterial stiffness. High-sensitivity C-reactive protein (hsCRP), serum amyloid A (SAA) and fibrinogen were measured as inflammatory indices using immunonephelometry. Results: In univariate analysis, PWVc-f was correlated with both loghsCRP (rZ0.28, pZ0.003) and fibrinogen (rZ0.29, pZ0.003) whereas PWVc-r was associated with loghsCRP (rZ0.21, pZ0.03) and logSAA (rZ0.22, pZ0.05). No correlation was found between AIx 75 and any of the measured biomarkers. After adjustment for several confounders, an independent association was observed between PWVc-f and loghsCRP (bZ0.24, pZ0.01) and fibrinogen (bZ0.16, pZ0.04) whereas an independent correlation was also emerged between PWVc-r and loghsCRP (bZ0.22, pZ0.02). Conclusion: In hypertensive patients with metabolic syndrome both hsCRP and fibrinogen are related to arterial stiffness but not to wave reflections. This finding elucidates the potential role of inflammation in arterial stiffening in patients with hypertension and metabolic syndrome and may have important clinical implications. P.080