Intima-Media Thickness and Pulsatility Index of Common Carotid Arteries in Acute Ischaemic Stroke Patients with Diabetes Mellitus

Bill, Olivier; Mazya, Michael V.; Michel, Patrik; Moreira, Tiago Prazeres; Lambrou, Dimitris; Meyer, Ivo; Hirt, Lorenz

doi:10.3390/jcm12010246

Cited by 8 publications

(6 citation statements)

References 44 publications

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“…The CIMT, RI, and PI values among the DM patients of cases showed no significant difference from the non-DM cases. However, a significant association between carotid Doppler ultrasonography variables and diabetes mellitus was found in some previous studies [24,28]. We have found significantly higher values of RI and PI in the left ICA of the older patients.…”

Section: Discussionsupporting

confidence: 47%

The Association of Carotid Plaque Size, Carotid Intima-Media Thickness, Resistive Index, and Pulsatility Index With Acute Ischemic Stroke

Kawnayn¹,

Kabir²,

Huq³

et al. 2023

Cureus

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Background: Carotid atherosclerosis is an important etiological factor for ischemic stroke. Early carotid lesion detection may prevent further strokes. Doppler ultrasound measures carotid artery blood flow, intimamedia thickness, stenosis, plaques, and lumen and wall changes.Objective: The objective of this study is to determine the association of carotid plaque size (CPS), carotid intima-media thickness (CIMT), resistive index (RI), and pulsatility index (PI) with acute ischemic stroke.Methodology: A total of 60 participants were taken, including 30 cases and 30 age-and sex-matched controls. Patients with acute ischemic stroke were included as cases and age-and sex-matched healthy volunteers were included as controls. A carotid duplex study was done in both groups, and the findings were compared.Results: The mean age of the ischemic stroke cases was 63.33±10.79 years; more than half were aged >60 years. Male patients were 73.3% and female patients were 26.7% of the cases. Age and gender were statistically similar (p>0.05) in groups (cases and controls). The plaques were homogenous in 30% of patients, calcified in 26.7%, and mixed in 6.7%. About 36.6% of patients did not have any plaque. CPS was greater among cases than controls in the right and left internal and left common carotid arteries; however, it was not statistically significant (p>0.05). The mean CIMT was 0.79±0.10 mm on the right side and 0.90±0.17 mm on the left side among cases. CIMT was significantly higher in the cases group than in the controls (p<0.05). The mean RI was significantly greater in the left common carotid artery (CCA) among the cases than in the controls (p<0.05). Patients aged over 60 years had significantly higher RI and PI values in the left internal carotid artery (ICA) compared to the younger cases (p<0.05). Smoking history had a significant association with left CCA RI and PI values (p<0.05). However, RI, PI, CPS, and CIMT among cases were similar in different groups like diabetic, non-diabetic, hypertensive, and non-hypertensive patients (p>0.05).Conclusion: CIMT was significantly thicker among the patients with ischemic stroke compared to the control group. RI in the left CCA was significantly greater among the stroke patients than in the control group. The age of the patient and smoking habit had an association with RI and PI values. Most of the parameters were found to be significant on the left side, suggesting carotid atherosclerosis may not be symmetrical. A largescale further study is needed to see the association of these variables with ischemic stroke patients.

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Section: Discussionsupporting

confidence: 47%

The Association of Carotid Plaque Size, Carotid Intima-Media Thickness, Resistive Index, and Pulsatility Index With Acute Ischemic Stroke

Kawnayn¹,

Kabir²,

Huq³

et al. 2023

Cureus

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“…Arterial stiffness has been implicated in the development of dementia (44), as it is associated with age-related differences in cerebrovascular conductance (27). In addition, patients with diabetes also demonstrate increased PI in the common carotid artery (45). Arterial stiffening, central pulse pressure, and forward wave energy are major contributors to the transmission of pulsatility into cerebral vessels (46) and could be damaging to the cerebral microvasculature.…”

Section: Discussionmentioning

confidence: 99%

Nordic Walking in Water on Cerebrovascular Reactivity and Cognitive Function in Elderly Patients with Type 2 Diabetes

PLOYDANG,

KHOVIDHUNKIT,

TANAKA

et al. 2023

Medicine &Amp; Science in Sports &Amp; Exercise

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Introduction Aquatic Nordic walking (ANW) is a novel whole-body low-impact exercise that can be practiced by a variety of older adults with chronic conditions. However, its efficacy on several aspects of health is largely unknown. Purpose This study aimed to determine the effects of regular ANW on glycemic control and vascular function in older adults with type 2 diabetes and mild cognitive impairment. Methods Thirty-three older adults with type 2 diabetes age 60–75 yr were randomly allocated to nonexercising control (n = 17) or ANW (n = 17) groups. Nordic walking was performed in a pool at water temperature of 34°C–36°C, three times per week for 12 wk. Results Measures of functional physical fitness including chair stand, timed up and go, chair sit and reach, reach and back scratch, and 6-min walk test scores were all improved after ANW (all P < 0.05). Plasma glucose, glycosylated hemoglobin, and homeostasis model assessment of insulin resistance decreased (all P < 0.05) in ANW. Vascular reactivity as assessed by brachial flow-mediated dilation increased, and arterial stiffness as assessed by brachial-ankle pulse wave velocity decreased in ANW (all P < 0.05). No significant changes were observed in the control group. Middle cerebral artery pulsatility index decreased with ANW under normocapnia condition (P < 0.05). Cerebrovascular conductance increased with ANW under hypercapnia condition. Montreal Cognitive Assessment score increased in the ANW group (P < 0.001). Changes in Montreal Cognitive Assessment scores were positively associated with corresponding changes in brain-derived neurotrophic factor (r = 0.540, P = 0.031). Conclusions Nordic walking in water was a safe and effective innovative exercise modality to improve glycemic control, vascular function, physical fitness, cerebrovascular reactivity, and cognitive function in older adults with type 2 diabetes.

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“…CIMT values are significantly higher in large vessel involvement (1.08 mm) than in small vessel involvement (0.92 mm) [ 13 ]. Diabetic patients were found to have increased CIMT values in parallel with more atherosclerotic changes compared to non-diabetic patients [ 14 ]. In a cohort of middle-aged women, metabolic syndrome was found to be more strongly associated with atherosclerosis as determined by CIMT than by the International Diabetes Federation definition or other definitions of metabolic health, and more strongly than BMI or waist circumference [ 15 ].…”

Section: Discussionmentioning

confidence: 99%

Factors Affecting Carotid Artery Stenosis in the Elderly Living at High Altitudes

Sukun,

Önal

2023

Cureus

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Background: Factors affecting carotid artery stenosis have been generally investigated. However, considering the protective effect of altitude, studies on elderly individuals at high altitudes are few. Our aim is to investigate the systematic adaptive changes caused by high-altitude exposure through the causes of carotid artery stenosis. Materials and methods: Carotid Doppler ultrasound was performed on 250 patients over the age of 50 years. The patients' age, gender, height, weight, smoking history, place of residence, and presence of comorbidities were questioned. Those with diabetes, hypertension, hyperlipidemia, and coronary disease were excluded from the study. Those who did not reside at high altitudes were excluded from the study. One hundred and thirty-five patients were included in the study. Carotid artery Doppler findings and biochemical parameters were recorded. Factors affecting stenosis in the carotid arteries were compared. Results: In our study, the factors affecting carotid stenosis were determined to be age, gender, presence of plaque, plaque type, and mean carotid intima-media thickness (CIMT). The mean CIMT of the patients was calculated as 0.71±0.14 mm. The mean CIMT measurement level was significantly higher in patients with plaque in the carotid artery (p<0.05). According to receiver operating characteristic curves, CIMT values higher than 0.72 mm increase plaque and stenosis formation in the common carotid artery (CCA) and internal carotid artery (ICA) in elderly people living at high altitudes (p<0.05, area under the curve [AUC]: 0.71-0.83). Conclusions: The most important factors affecting carotid stenosis in individuals living at high altitudes are age, gender, CIMT, plaque, and plaque type. When soft plaques were detected, the risk of stenosis was found to be higher than in calcific plaques. Additionally, the number of factors affecting stenosis was greater on the left (ICA). This suggests that the left carotid system is more vulnerable. It can be said that in elderly individuals living at high altitudes, a CIMT higher than 0.72 mm is a cutoff value in the presence of plaque and stenosis in the carotid arteries.

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Intima-Media Thickness and Pulsatility Index of Common Carotid Arteries in Acute Ischaemic Stroke Patients with Diabetes Mellitus

Cited by 8 publications

References 44 publications

The Association of Carotid Plaque Size, Carotid Intima-Media Thickness, Resistive Index, and Pulsatility Index With Acute Ischemic Stroke

The Association of Carotid Plaque Size, Carotid Intima-Media Thickness, Resistive Index, and Pulsatility Index With Acute Ischemic Stroke

Nordic Walking in Water on Cerebrovascular Reactivity and Cognitive Function in Elderly Patients with Type 2 Diabetes

Factors Affecting Carotid Artery Stenosis in the Elderly Living at High Altitudes

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