Carotid body size on CTA: Correlation with comorbidities

Cramer, Justin A.; Wiggins, Richard H.; Fudim, Marat; Engelman, Zoar J.; Sobotka, Paul A.; Shah, Lubdha M.

doi:10.1016/j.crad.2013.08.016

Cited by 36 publications

(32 citation statements)

References 18 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…In animal models, resection of the CB or inhibition of its output by hyperoxia improves HTN, CHF and diabetes mellitus (DM) 4–7 . In humans, the size of the CB correlates with the prevalence of sympathetically mediated diseases such as HTN, CHF and DM 8, 9 , CB hypersensitivity relates to increased mortality in CHF 10 , and hyperoxia improves hemodynamic characteristics of CHF 11 ; hence, CB resection has been attempted as a possible treatment for patients with advanced CHF 12 .…”

Section: Introductionmentioning

confidence: 99%

Effects of carotid body tumor resection on the blood pressure of essential hypertensive patients

Fudim

Groom

Laffer

et al. 2015

Journal of the American Society of Hypertension

View full text Add to dashboard Cite

Removal of the carotid body (CB) improves animal models of hypertension (HTN) and heart failure, presumably via withdrawal of chemoreflex-induced sympathetic activation. The effect of CB tumor (CBT) resection on blood pressure (BP) in subjects with HTN is unknown. We conducted a retrospective analysis of 20 subjects with HTN (BP≥140/90 mmHg or use of antihypertensives) out of 134 who underwent CBT resection. Short-term (from 3 months before to the first reading after 30 days from surgery) and long-term (slope of the regressions on time over the entire follow up) changes in BP and heart rate (HR) were ascertained and adjusted for covariates (interval between readings, total follow up, number of readings and changes in therapy). Age and duration of HTN were 56±4 and 9±5 years. Adjusted short-term decreases in systolic (SBP: −9.9±3.1, p<0.001) and pulse pressures (PP: −7.9±2.7, p<0.002) were significant and correlated with their respective long-term changes (SBP: r=0.47, p=0.047; PP: r=0.54, p=0.019). Also, there was a strong relationship between adjusted short-term changes in SBP and PP (r=0.64, p<0.004). Out of 12 subjects with concordant decreases in short-and long-term BP changes, 6 (50% of responders or 33% of the total) had short-term falls of SBP ≥10 mmHg and of PP ≥ 5mmHg. To our knowledge this study is the first to show that unilateral CBT resection is associated with sustained reduction of BP in subjects with HTN. Hence, we suggest that targeted removal of the CB chemoreflex conceivably has a role in the therapy of human HTN.

show abstract

Section: Introductionmentioning

confidence: 99%

Effects of carotid body tumor resection on the blood pressure of essential hypertensive patients

Fudim

Groom

Laffer

et al. 2015

Journal of the American Society of Hypertension

View full text Add to dashboard Cite

show abstract

“…Alterations of CB development or function have been implicated in several respiratory diseases, particularly in the newborn (reviewed by (LopezBarneo et al 2008 )). On the other hand, CB over-activation appears to contribute to the autonomic imbalance characteristic of several highly prevalent disorders, such as obesity, hypertension, obstructive sleep apnea, metabolic syndrome, cardiac failure, and diabetes (Cramer et al 2014 ;Iturriaga 2013 ;Nair et al 2013 ;Narkiewicz et al 1998 ;Prabhakar and Semenza 2012 ;Ribeiro et al 2013 ;Schultz et al 2013 ). Recently, ablation of this organ has been proposed for the treatment of neurogenic hypertension .…”

Section: Introductionmentioning

confidence: 97%

Neurotrophic Properties, Chemosensory Responses and Neurogenic Niche of the Human Carotid Body

Ortega-Sáenz

Villadiego

Pardal

et al. 2015

Advances in Experimental Medicine and Biology

View full text Add to dashboard Cite

The carotid body (CB) is a polymodal chemoreceptor that triggers the hyperventilatory response to hypoxia necessary for the maintenance of O(2) homeostasis essential for the survival of organs such as the brain or heart. Glomus cells, the sensory elements in the CB, are also sensitive to hypercapnia, acidosis and, although less generally accepted, hypoglycemia. Current knowledge on CB function is mainly based on studies performed on lower mammals, but the information on the human CB is scant. Here we describe the structure, neurotrophic properties, and cellular responses to hypoxia and hypoglycemia of CBs dissected from human cadavers. The adult CB parenchyma contains clusters of chemosensitive glomus (type I) and sustentacular (type II) cells as well as nestin-positive progenitor cells. This organ also expresses high levels of the dopaminotrophic glial cell line-derived neurotrophic factor (GDNF). GDNF production and the number of progenitor and glomus cells were preserved in the CBs of human subjects of advanced age. As reported for other mammalian species, glomus cells responded to hypoxia by external Ca(2+)-dependent increase of cytosolic [Ca(2+)] and quantal catecholamine release. Human glomus cells are also responsive to hypoglycemia and together the two stimuli, hypoxia and hypoglycemia, can potentiate each other's effects. The chemo-sensory responses of glomus cells are also preserved at an advanced age. Interestingly, a neurogenic niche similar to that recently described in rodents is also preserved in the adult human CB. These new data on the cellular and molecular physiology of the CB pave the way for future pathophysiological studies involving this organ in humans.

show abstract

“…Long-standing evidence from patient populations has shown that those individuals who exhibit chronic hypoxemia also exhibit increased carotid body volume and/or carotid body hyperplasia (Arias-Stella and Valcarcel, 1976; Cramer et al, 2014; Habeck, 1986; Heath and Smith, 1994; Vinhaes et al, 2002). Such conditions include, but are not limited to: acute respiratory disease syndrome (Vinhaes et al, 2002), pulmonary emphysema (Heath and Smith, 1994), chronic obstructive pulmonary disease (Vinhaes et al, 2002), patients with severe lung diseases (Habeck, 1986), and high altitude natives (Arias-Stella and Valcarcel, 1976).…”

Section: Introductionmentioning

confidence: 99%

“…The post-mortem nature of these assessments has understandable limitations to our ability to adequately interpret the clinical relevance of such results. However, recent work suggests the carotid body may be visible in up to 80% of normal adults undergoing computed tomography angiography (CTA) (Cramer et al, 2014; Nair et al, 2013). Thus, CTA has emerged as a potential new way to assess carotid body size in living individuals.…”

Section: Introductionmentioning

confidence: 99%

“…With this, CTA may provide an important screening tool to help identify individuals who exhibit increased carotid body size and may benefit from procedures such as carotid body denervation or resection. Using neck CTA, recent data suggest patients with diabetes mellitus, hypertension, and congestive heart failure exhibit a 20–25% larger mean carotid body size when compared with controls (Cramer et al, 2014). With this in mind, we sought to examine whether carotid body size detected by CTA would be increased in individuals with diagnosed sleep disordered breathing.…”

Section: Introductionmentioning

confidence: 99%

See 1 more Smart Citation

Impact of sleep disordered breathing on carotid body size

Welch

Petersen‐Jones

Eugene

et al. 2017

Respiratory Physiology & Neurobiology

View full text Add to dashboard Cite

We tested the hypotheses that: 1) carotid body size can be measured by computed tomographic angiography (CTA) with high inter-observer agreement, and 2) patients with sleep apnea exhibit larger carotid bodies than those without sleep apnea. A chart review was conducted from patients who underwent neck CTA and polysomnography at the Mayo Clinic between January 2000 and February 2015. Widest axial measurements of the carotid bodies, performed independently by two radiologists, were possible in 81% of patients. Intra-class correlation coefficients ranged from 0.93 to 0.95 (Right carotid body: 0.93; Left: 0.94; Average: 0.95). Widest axial measurements of the carotid bodies were greater in patients with sleep apnea (n=32) compared to controls (n=46, P-value range 0.02–0.04). After adjusting for age, no differences in carotid body size were observed between the patient groups (P-value range 0.45–0.59). We conclude carotid body size can be detected by CTA with high inter-observer agreement; however carotid body size is not increased in patients with sleep apnea.

show abstract

Carotid body size on CTA: Correlation with comorbidities

Cited by 36 publications

References 18 publications

Effects of carotid body tumor resection on the blood pressure of essential hypertensive patients

Effects of carotid body tumor resection on the blood pressure of essential hypertensive patients

Neurotrophic Properties, Chemosensory Responses and Neurogenic Niche of the Human Carotid Body

Impact of sleep disordered breathing on carotid body size

Contact Info

Product

Resources

About