Increased arterial stiffening and thickening in the paretic lower limb in patients with hemiparesis

Abstract

Atherosclerosis has two key components, thickening and stiffening of arterial wall. These parameters are quantified ultrasonographically by IMT (intima-media thickness) and PWV (pulse wave velocity). In the present study, we determined the FA IMT (IMT of the bilateral femoral artery) and PWV of femoral-ankle (PWV fa) and brachial-ankle (PWV ba) segments in order to examine whether the degree of atherosclerosis is different between paretic and non-paretic lower limbs in 24 patients with hemiparesis. The values of PWV fa, PWV ba and FA IMT were all significantly greater on the paretic than the non-paretic side. Furthermore, significant decreases in masses of muscle, bone and fat, determined by dual-energy X-ray absorptiometry, were observed in paretic lower limbs compared with the non-paretic side. PWV fa correlated significantly and negatively with muscle mass ( r =-0.488, P =0.0004) and tended to correlate negatively with BMC (bone mineral content; r =-0.264, P =0.069) when statistical analyses were performed with the paretic and non-paretic sides together. Multiple regression analysis elucidated that the muscle mass was associated significantly with PWV fa and PWV ba, independent of age, duration after cerebrovascular accident, gender, bone and fat mass and FA IMT. The muscle mass was still associated with increased PWV fa and PWV ba when multivariate analysis was conducted independently in the paretic and non-paretic sides. In summary, our results indicated that arterial thickening and stiffening were greater on the paretic than the non-paretic side and suggested that a decrease of muscle mass might be associated with increased arterial stiffening in the paretic lower limb.

Increased Pulse Wave Velocity in Subclinical Hypothyroidism

“…Not only aortic PWV but also baPWV has been shown to be a good independent predictor for the presence of coronary artery disease in men (11,12). Thus far, we have reported the significance of baPWV in patients with hemiparesis (13). Although subclinical hypothyroidism is a major risk factor for atherosclerosis, few studies have been performed on arterial stiffening using baPWV measurements in subclinical hypothyroid patients.…”

“…An automatic waveform analyzer (model BP-203RPE; Colin Co., Komaki, Japan) was used to measure PWV simultaneously with blood pressure, electrocardiogram, and heart sounds, as we and others have previously described (10,13). Briefly, subjects were examined in the supine position after 5 min of bed rest, with electrocardiogram electrodes placed on both wrists, a microphone for detecting heart sounds placed on the left edge of the sternum, and cuffs wrapped around the brachium and ankles.…”

Higher serum bone alkaline phosphatase as a predictor of mortality in male hemodialysis patients

“…We have shown that abdominal aortic calcification is significantly associated with all-cause mortality in maintenance hemodialysis patients (Okuno et al, 2007). Reduced bone mineral density (BMD) has been linked to increased arterial thickness and stiffness based on increased intima-media thickness (Yamada et al, 2005) and pulse wave velocity in Japanese subjects (Tanaka et al, 2006;Okabe et al, 2004). Furthermore, we have shown that the rate of reduction of BMD is an independent predictor of all-cause mortality in male hemodialysis patients and that the presence of vertebral fracture predicts mortality in female hemodialysis patients .…”

Relationship between serum TSH levels and intrarenal hemodynamic parameters in euthyroid subjects

“…Clinically overt and subclinical hypothyroidism is associated with a high rate of chronic kidney disease (CKD) (1,2,3,4,5,6,7) and is an established cardiovascular risk factor (1). Subclinical hypothyroidism occurs in 5-15% of the general population and is highly prevalent in women over 60 years of age (1,2).…”