Predictive Value of Carotid Bruit for Carotid Atherosclerosis

Ingall, Timothy J.; Homer, Daniel; Whisnant, Jack P.; Baker, Hillier L.; O’Fallon, W. Michael

doi:10.1001/archneur.1989.00520400078023

Cited by 40 publications

(14 citation statements)

References 29 publications

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“…Our results are also similar to those of Ingall et al, 14 who recently reported non-site-specific atherosclerosis of >50% stenosis (measured angiographically) in 35% of patients with no bruit but in approximately 85% of those with a unilateral bruit. However, Ingall et al 14 detected no further increase in patients with bilateral bruits.…”

Section: Discussionsupporting

confidence: 92%

“…However, Ingall et al 14 detected no further increase in patients with bilateral bruits. We document a similarly large difference between average B-mode plaque score in patients with no bruit and in those with a unilateral bruit, but a much smaller (though significant) difference between patients with a unilateral bruit and those with bilateral bruits.…”

Section: Discussionmentioning

confidence: 92%

“…Most recently, Ingall et al 14 have started the movement back toward the position of bruits being valuable predictors of carotid atherosclerosis. These authors reported moderate-to-severe carotid atherosclerosis (>50% stenosis) evaluated by angiography in >80% of 196 patients with bruits and similar stenosis in only 35% of 1,151 patients without bruit.…”

mentioning

confidence: 99%

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Correlation of carotid bruits and carotid atherosclerosis detected by B-mode real-time ultrasonography.

Howard

Harpold

et al. 1989

Stroke

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The extent of carotid atherosclerosis evaluated by B-mode real-time ultrasound and the presence of bruits established by carotid phonoangiography were determined in 1,107 patients. Unilateral bruit was associated with increased atherosclerosis compared with no bruit {p <0.0001). However, there was no association between laterality of the bruit and the degree of atherosclerosis (/7=0.66). There was marginal evidence that patients with bilateral bruits had more severe atherosclerosis than patients with unilateral bruit (p=0.046). The relation between bruit and atherosclerosis categorized by B-mode ultrasound was not sufficient to reliably predict the presence or absence of disease in an individual patient, though the presence of a bruit should be viewed as a risk factor for, or an indicator of, increased risk of systemic atherosclerosis. {Stroke 1989;20:1331-1335)

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Section: Discussionsupporting

confidence: 92%

Section: Discussionmentioning

confidence: 92%

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Correlation of carotid bruits and carotid atherosclerosis detected by B-mode real-time ultrasonography.

Howard

Harpold

et al. 1989

Stroke

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“…9 These data indicate that either a diffuse or a localized carotid bruit is approximately 85% predictive of an underlying moderate to high-grade carotid stenosis in patients with cerebral ischemic symptoms.…”

Section: Discussionmentioning

confidence: 78%

Prospective comparison of a cohort with asymptomatic carotid bruit and a population-based cohort without carotid bruit.

Wiebers

Whisnant

Sandok

et al. 1990

Stroke

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This study is a prospective analysis of the predictive value of diffuse and localized carotid bruit. Patients with asymptomatic carotid bruits are compared with a population-based age-and sex-matched control group known not to have carotid bruit, in regard to subsequent transient ischemic attack, stroke, and death. Each person was followed until death or for 5 years. Among the 566 patients with asymptomatic carotid bruit, the annual stroke rate given survival was 1.5%/yr or 7.5% at 5 years by actuarial analysis. The annual stroke rate given survival for the 428 patients in the population-based cohort was 0.5%/yr or 2.4% at 5 years. Patients with localized carotid bruit were not significantly different from those with diffuse carotid bruits in regard to subsequent cerebral ischemic events (p=0.11). These data indicate that patients with asymptomatic diffuse or localized carotid bruit are approximately three times more likely to have ischemic stroke than an age-and sex-matched population sample known not to have carotid bruit. (Stroke 1990;21:984-988) T he proper management of patients with asymptomatic carotid bruits remains controversial. The number of patients with this disorder is large; approximately 12.6% of the population aged >45 years have been noted to have some type of cervical murmur.1 Approximately one third of these murmurs are localized mid-carotid bifurcation bruits, and about three fourths of the persons with localized bruit have not had cerebral or retinal ischemic symptoms.When the clinician auscultates a localized or diffuse carotid bruit, the question of whether to perform further noninvasive or invasive diagnostic procedures or to treat the patient with antiplatelet or anticoagulant agents or carotid endarterectomy is raised. The purpose of this study was to provide a prospective analysis of the predictive value of diffuse and localized carotid bruit in a sample of patients compared with a population-based age-and sex-matched control group without carotid bruit in regard to subsequent transient ischemic attack (TIA), ischemic and hemorrhagic stroke, and death.

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“…The predictive value of carotid bruits for carotid arteriosclerotic lesions is at least questionable. 17,18 However, the carotid intima-media thickness is considered as independent predictor for cardiovascular death in patients on HD or PD, and is associated with left ventricular hypertrophy. 19 Apparently, the W-H ratio, the number of packyears, and the onset (acute or chronic) and the duration of the kidney disease (pre-RRT, RRT, kidney disease, RTx) did not predict a prolonged AT.…”

Section: Prognostic Factors Wl Diemont Et Almentioning

confidence: 99%

Prognostic factors for the vascular components of erectile dysfunction in patients on renal replacement therapy

et al. 2003

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A total of 76 male patients on renal replacement therapy (RRT) were investigated. Erectile dysfunction (ED) was defined as insufficient erection during visual erotic stimulation (VES) or during sleep as measured with Rigiscan s and Erectiometer s . Data on medical history, physical examination, and laboratory variables were collected. Furthermore, penile pharmacological duplex ultrasonography (PPDU) was performed. Univariate and multivariate logistic regressions were used to determine prognostic values and to develop prognostic models. Independent prognostic factors for ED were the number of cardiovascular events, waist-hip ratio, body mass index, and acceleration time (AT) as measured with PPDU. Independent prognostic factors for an abnormal AT (4100 ms) were number of cardiovascular events, age category, and the presence of carotid bruits. Independent prognostic factors for insufficient veno-occlusion during PPDU were number of cardiovascular events and supine diastolic blood pressure. The vascular contribution to ED in patients on RRT is substantial. Data from medical history, limited physical examination, and PPDU contribute to the prediction of the vascular contribution to ED.

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Predictive Value of Carotid Bruit for Carotid Atherosclerosis

Cited by 40 publications

References 29 publications

Correlation of carotid bruits and carotid atherosclerosis detected by B-mode real-time ultrasonography.

Correlation of carotid bruits and carotid atherosclerosis detected by B-mode real-time ultrasonography.

Prospective comparison of a cohort with asymptomatic carotid bruit and a population-based cohort without carotid bruit.

Prognostic factors for the vascular components of erectile dysfunction in patients on renal replacement therapy

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