Evidence for greater burden of peripheral arterial disease in lower extremity arteries of spinal cord-injured individuals

Bell, Jeffrey W.; Chen, David; Bahls, Martin; Newcomer, Sean C.

doi:10.1152/ajpheart.00507.2011

Cited by 25 publications

(36 citation statements)

References 37 publications

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“…2 Subjects were not required to arrive for testing in a fasted state nor were they required to abstain from caffeine, tobacco, or medication usage prior to testing. The lower-extremity arteries of interest included the superficial femoral and popliteal arteries.…”

Section: Experimental Protocolmentioning

confidence: 99%

“…Anatomical landmarks for ultrasound imaging were previously described. 2 Briefly, the superficial femoral artery was imaged in the subsartorial canal distal to the bifurcation of the common femoral artery. Popliteal artery images were obtained in the popliteal fossa superior to the bifurcation into the anterior and posterior tibialis arteries.…”

Section: Experimental Protocolmentioning

confidence: 99%

“…2 Briefly, the diameter was determined via ultrasound (Terason T3000, Burlington, MA, USA) utilizing a variable-frequency transducer …”

Section: Measurementsmentioning

confidence: 99%

“…2 These extensive changes in the lower-extremity arteries may better explain increased cardiovascular disease risk 3 in individuals with SCI. In individuals with SCI, the lower-extremity artery adaptations include significant reductions in lower-extremity artery diameter 1 and increases in mean blood velocity, 4 which produce mean wall shear rates that are approximately double those reported in ablebodied individuals.…”

Section: Introductionmentioning

confidence: 99%

“…Furthermore, SCI has been reported to produce an increase in intima-media thickness in some of the lower-extremity arteries of people with SCI. 2 Unfortunately, reports of altered arterial structure and hemodynamics in individuals with SCI have used relatively small populations, and are mostly limited to the common and superficial femoral arteries. 1,4,12 For this reason it is difficult to generalize these changes to larger populations and other lower-extremity arteries affected by SCI.…”

Section: Introductionmentioning

confidence: 99%

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Altered resting hemodynamics in lower-extremity arteries of individuals with spinal cord injury

Bell

Chen

Bahls

et al. 2013

The Journal of Spinal Cord Medicine

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Objective: To investigate lower-extremity arterial hemodynamics in individuals with spinal cord injury (SCI). We hypothesized that oscillatory shear index would be altered and resting mean shear would be higher in the lowerextremity arteries of SCI. Research: Cross-sectional study of men and women with SCIs compared to able-bodied controls. Subjects: Subjects included 105 ages 18-72 years with American Spinal Injury Association (ASIA) Impairment Scale grades A, B, or C and injury duration at least 5 years. Subjects were matched for age and cardiovascular disease risk factors with 156 able-bodied controls. Methods: Diameter and blood velocity were determined with subject at rest via ultrasound in superficial femoral, popliteal, brachial, and carotid arteries. Mean shear, antegrade shear, retrograde shear, and oscillatory shear index were calculated. Results: Oscillatory shear index was lower in SCI compared to controls for superficial femoral (0.16 ± 0.10 vs. 0.26 ± 0.06, P < 0.01) and popliteal arteries (0.20 ± 0.11 vs. 0.26 ± 0.05, P < 0.01). Mean shear rate was higher in SCI compared to controls for superficial femoral (43.54 ± 28.0 vs. 20.48 ± 13.1/second, P < 0.01) and popliteal arteries (30.43 ± 28.1 vs. 11.68 ± 9.5/second, P < 0.01). Conclusions: The altered resting hemodynamics in SCI are consistent with an atheroprotective hemodynamic environment.

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Section: Experimental Protocolmentioning

confidence: 99%

Section: Experimental Protocolmentioning

confidence: 99%

“…2 Briefly, the diameter was determined via ultrasound (Terason T3000, Burlington, MA, USA) utilizing a variable-frequency transducer …”

Section: Measurementsmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

See 3 more Smart Citations

Altered resting hemodynamics in lower-extremity arteries of individuals with spinal cord injury

Bell

Chen

Bahls

et al. 2013

The Journal of Spinal Cord Medicine

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Coronary and carotid imaging of atherosclerosis and contributing factors in middle‐aged people with long‐term cervical and upper thoracic spinal cord injuries

Hill

Jörgensen

Engström

et al. 2023

PM&R

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IntroductionCardiovascular disease (CVD) is a major cause of death in people aging with spinal cord injury (SCI), and is predominantly caused by atherosclerosis, however, knowledge of atherosclerosis in people with SCI is scarce.ObjectiveTo describe coronary and carotid atherosclerosis in middle‐aged people with long‐term cervical and upper thoracic SCI using coronary computed tomography angiography, carotid ultrasound, and CVD risk factors, and to compare with the general population.DesignCross‐sectional study with matched controls.SettingOutpatient SCI unit in southern Sweden.ParticipantsParticipants (n=25) in the Swedish SPinal Cord Injury Study on Cardiopulmonary and Autonomic Impairment (SPICA) (20% women, mean age 58 years, mean time since injury 28 years, injury levels C2‐T6, American Spinal Injury Association Impairment Scale A‐C). Non‐SCI controls (n=125; ratio 5:1) from the Swedish CArdioPulmonary bioImage Study (SCAPIS).InterventionsNot applicableMain Outcome MeasuresPresence of coronary atherosclerosis, coronary artery calcium score (CACS), carotid plaques, carotid intima media thickness, blood pressure, lipids, Systematic Coronary Risk Evaluation (SCORE) and anthropometry.ResultsCoronary and carotid atherosclerotic plaques occurred in 44% of the participants, 67% of the controls exhibited coronary and 59% carotid plaques; odds ratios (OR; 95% CI): 0.38 (0.13‐1.17) and 0.54 (0.22‐1.32), respectively. Mean number of segments with coronary atherosclerosis were 1.0 in participants and 2.1 in controls (OR: 0.74 [0.52‐1.06]). CACS >100 occurred in 4 (18%) of the participants and 23 (21%) of the controls. The participants had significantly lower levels of total and non‐high density lipoprotein cholesterol and SCORE than the controls.ConclusionsThis is the first comprehensive assessment of atherosclerosis in people with SCI using advanced imaging techniques. The atherosclerotic burden in middle‐aged people with long‐term cervical and upper thoracic SCI was not increased, whereas SCORE was lower due to lower cholesterol levels. Imaging techniques may be valuable tools for assessment of atherosclerosis in SCI.This article is protected by copyright. All rights reserved.

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Determination of Vascular Reactivity of Middle Cerebral Arteries from Stroke and Spinal Cord Injury Animal Models Using Pressure Myography

Anwar

Eid

2016

Methods in Molecular Biology

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Stroke and other neurovascular derangements are main causes of global death. They, along with spinal cord injuries, are responsible for being the principal cause of disability due to neurological and cognitive problems. These problems then lead to a burden on scarce financial resources and societal care facilities as well as have a profound effect on patients' families. The mechanism of action in these debilitating diseases is complex and unclear. An important component of these problems arises from derangement of blood vessels, such as blockage due to clotting/embolism, endothelial dysfunction, and overreactivity to contractile agents, as well as alteration in endothelial permeability. Moreover, the cerebro-vasculature (large vessels and arterioles) is involved in regulating blood flow by facilitating auto-regulatory processes. Moreover, the anterior (middle cerebral artery and the surrounding region) and posterior (basilar artery and its immediate locality) regions of the brain play a significant role in triggering the pathological progression of ischemic stroke particularly due to inflammatory activity and oxidative stress. Interestingly, modifiable and non-modifiable cardiovascular risk factors are responsible for driving ischemic and hemorrhagic stroke and spinal cord injury. There are different stroke animal models to examine the pathophysiology of middle cerebral and basilar arteries. In this context, arterial myography offers an opportunity to determine the etiology of vascular dysfunction in these diseases. Herein, we describe the technique of pressure myography to examine the reactivity of cerebral vessels to contractile and vasodilator agents and a prelude to stroke and spinal cord injury.

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Evidence for greater burden of peripheral arterial disease in lower extremity arteries of spinal cord-injured individuals

Cited by 25 publications

References 37 publications

Altered resting hemodynamics in lower-extremity arteries of individuals with spinal cord injury

Altered resting hemodynamics in lower-extremity arteries of individuals with spinal cord injury

Coronary and carotid imaging of atherosclerosis and contributing factors in middle‐aged people with long‐term cervical and upper thoracic spinal cord injuries

Determination of Vascular Reactivity of Middle Cerebral Arteries from Stroke and Spinal Cord Injury Animal Models Using Pressure Myography

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