Cortical Ischemic Lesion Burden Measured by DIR Is Related to Carotid Artery Disease Severity

2014 ◽  
Vol 39 (1) ◽  
pp. 23-30 ◽  
Author(s):  
Doriana Landi ◽  
Paola Maggio ◽  
Domenico Lupoi ◽  
Paola Palazzo ◽  
Claudia Altamura ◽  
...  
Keyword(s):  
Risk Factors ◽  
Carotid Artery ◽  
Disease Severity ◽  
Carotid Artery Disease ◽  
Carotid Disease ◽  
Ischemic Lesion ◽  
Cerebrovascular Risk ◽  
Artery Disease ◽  
The Impact

Background: Over time, exposure to cerebrovascular risk factors and carotid artery disease may cause multiple asymptomatic brain cortical and subcortical microinfarcts, which are commonly found at brain autopsy. So far, lack of convenient neuroimaging tools limited the investigation of grey matter ischemic damage in vivo. We applied the Double Inversion Recovery (DIR) sequence to explore the impact of carotid artery disease on intracortical ischemic lesion load in vivo, taking into account the impact of demographic characteristics and vascular risk factors. Methods: DIR was acquired in 62 patients with common cerebrovascular risk factors stratified in three groups according to carotid artery disease severity. Intracortical lesions scored on DIR (DIRlns) were classified by vascular territory, lobe and hemisphere. White matter hyperintensities (WMHs) volume was also quantified on Fluid Attenuated Inversion Recovery sequence (FLAIR). Results: Among demographic characteristics and cerebrovascular risk variables explored, General Linear Model indicated that age and carotid artery disease were significantly associated to DIRlns. After correcting for age, DIRlns load was found to be significantly dependent on carotid artery stenosis severity (F(2, 58) = 5.56, p = 0.006). A linear positive correlation between DIRlns and WMHs was found after correcting for age (p = 0.003). Conclusions: Carotid disease severity is associated with DIRlns accrual. Microembolism and impaired cerebral hemodynamics may act as physiopathological mechanisms underlying cortical ischemic damage. The role of other factors, such as small vessel disease and the possible interaction with carotid disease, remains to be further explored.

scholarly journals Epidemiological aspects of carotid disease

2021 ◽  
Vol 13 (1) ◽  
Author(s):  
Savetka Paljoskovska-Jordanova
Keyword(s):  
Risk Factors ◽  
Carotid Artery ◽  
Peripheral Arterial Disease ◽  
Carotid Stenosis ◽  
Carotid Artery Disease ◽  
Arterial Disease ◽  
Carotid Disease ◽  
Artery Disease ◽  
Peripheral Arterial ◽  
The University

Carotid artery disease most commonly manifests as atherosclerotic carotid artery disease, which can lead to an ischemic stroke. Our aim was to present the epidemiological aspects of carotid disease and to demonstrate the association of risk factors with carotid disease. For that purpose, we prospectively followed 1031 patients at the University Clinic for Cardiology in Skopje, who were examined for carotid stenosis and its correlation with risk factors such as hypertension, smoking, hyperlipidemia, diabetes, obesity and peripheral arterial disease. Results: Carotid stenosis was correlated with arterial hypertension, hyperlipidemia, diabetes mellitus, smoking, and peripheral arterial disease. Conclusions: Our study found that conventional risk factors such as hypertension, diabetes, smoking, and dyslipidemia were independently associated with significant carotid artery disease and peripheral arterial disease.

scholarly journals Toll-like receptor 2 and 4 stimulation elicits an enhanced inflammatory response in human obese patients with atherosclerosis

2011 ◽  
Vol 121 (5) ◽  
pp. 205-214 ◽  
Author(s):  
Vincent P.W. Scholtes ◽  
Dik Versteeg ◽  
Jean-Paul P.M. de Vries ◽  
Imo E. Hoefer ◽  
Arjan H. Schoneveld ◽  
...  
Keyword(s):  
Risk Factors ◽  
Cardiovascular Risk ◽  
Carotid Artery ◽  
Cardiovascular Risk Factors ◽  
Carotid Artery Disease ◽  
Innate Immune ◽  
Obese Patients ◽  
Cd11b Expression ◽  
Activation Marker ◽  
Artery Disease

The innate immune response elicited by activation of TLRs (Toll-like receptors) plays an important role in the pathogenesis of atherosclerosis. We hypothesized that cardiovascular risk factors are associated with the activation status of the innate immune system. We therefore assessed the responsiveness of TLRs on circulating cells in two groups of patients with established atherosclerosis and related this to the presence of cardiovascular risk factors. TNF (tumour necrosis factor)-α release induced by TLR2 and TLR4 activation was measured in patients with established coronary [PCI (percutaneous coronary intervention) study, n=78] or carotid artery disease [CEA (carotid endarterectomy) study, n=104], by stimulating whole blood samples with lipopolysaccharide (TLR4 ligand) and Pam3CSK4 [tripalmitoylcysteinylseryl-(lysyl)4; TLR2 ligand]. As an early activation marker, CD11b expression was measured by flow cytometry on CD14+ cells. Obesity was the ‘only’ risk factor that correlated with the TLR response. In both studies, obese patients had significantly higher TNF-α levels after stimulation of TLR2 compared with non-obese patients [16.9 (7.7–49.4) compared with 7.5 (1.5–19.2) pg/ml (P=0.008) in coronary artery disease and 14.6 (8.1–28.4) compared with 9.5 (6.1–15.7) pg/ml (P=0.015) in carotid artery disease; values are medians (interquartile range)]. Similar results were obtained following TLR4 stimulation. The enhanced inflammatory state in obese patients was also confirmed by a significant increased expression of the activation marker CD11b on circulating monocytes. In conclusion, obesity is associated with an enhanced TLR response in patients suffering from established atherosclerotic disease.

scholarly journals Nontraditional Risk Factors in Carotid Artery Disease

2010 ◽  
Vol 16 (5) ◽  
pp. 554-558 ◽  
Author(s):  
Zeynep G. Ozturk ◽  
Hakan Ekmekci ◽  
Ozlem B. Ekmekci ◽  
Pinar Atukeren ◽  
Ilknur Butun ◽  
...  
Keyword(s):  
Risk Factors ◽  
Carotid Artery ◽  
Carotid Artery Disease ◽  
Asymptomatic Group ◽  
Carotid Artery Plaque ◽  
Lipoprotein A ◽  
Symptomatic Group ◽  
Tnf Α ◽  
Artery Disease ◽  
Factor Α

Carotid atherosclerosis (AS) is one of the main risk factors for ischemic stroke. Our aim is to evaluate the nontraditional biochemical markers in asymptomatic and symptomatic patients with carotid artery plaque. This study was conducted on 55 patients: 43 with symptomatic and 12 with asymptomatic carotid artery disease. Lipoprotein (a) (Lp(a)), homocysteine, adiponectin, nitric oxide (NO), and tumor necrosis factor α (TNF-α) levels were measured in the plasma. The mean of total cholesterol, triglyceride, and homocysteine levels was significantly elevated in the symptomatic group as compared with the asymptomatic group (P = .03). In the asymptomatic group, adiponectin and NO levels showed elevations as compared with the symptomatic group but this increase was not significant (P > .05). Lipoprotein (a) and TNF-α levels acted inversely with adiponectin and NO. There was an insignificant decline in Lp(a) and TNF-α levels in the asymptomatic group as compared with the symptomatic group (P > .05).

Correlation of Carotid Artery Disease Severity and Vasomotor Response of Cerebral Blood Vessels

Angiology ◽  
2014 ◽  
Vol 66 (5) ◽  
pp. 481-487 ◽  
Author(s):  
Ivana Krdžić ◽  
Nadežda Čovičković-Šternić ◽  
Niki Katsiki ◽  
Esma R. Isenović ◽  
Đorđe Radak
Keyword(s):  
Carotid Artery ◽  
Blood Vessels ◽  
Disease Severity ◽  
Carotid Artery Disease ◽  
Vasomotor Response ◽  
Cerebral Blood Vessels ◽  
Artery Disease

scholarly journals Carotid Artery Disease in Diabetic Patients

PRILOZI ◽  
2014 ◽  
Vol 35 (3) ◽  
pp. 149-161 ◽  
Author(s):  
Marijan Bosevski
Keyword(s):  
Diabetes Mellitus ◽  
Risk Factors ◽  
Carotid Artery ◽  
Carotid Artery Disease ◽  
Intima Media Thickness ◽  
Carotid Intima Media Thickness ◽  
Diabetic Patients ◽  
Symptomatic Carotid ◽  
Main Determinants ◽  
Artery Disease

AbstractThere are two points of view on the interplay between carotid artery disease and diabetes mellitus: Diabetes mellitus has been recognized as one of the main determinants for the presence and progression of asymptomatic and symptomatic carotid artery disease; and carotid intima-media thickness has been defined as a useful tool for risk stratification of this population.Hyperglycaemia, duration of diabetes, arterial hypertension, cholesterol and inflammatory markers have previously been determined as independent factors for carotid atherosclerosis in diabetes, and aging as its predictor in this population by our own results. This paper focuses on the particularities of risk factors in diabetic patients (especially in type 2) and evidence-based guidelines for the management and risk reduction of these patients with stroke and/or carotid artery disease.At present, carotid ultrasound is recommended in diabetic patients with cerebrovascular symptoms. Since the prevalence of diabetes increases constantly, we attempt to address refreshment of criteria for screening of carotid artery disease in the diabetic population. It could be recommended for diabetic patients with at least one more risk factors and for diabetic patients above 60 years of age.

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