Association between Carotid Hemodynamics and Asymptomatic White and Gray Matter Lesions in Patients with Essential Hypertension

Kurata, Mie; Okura, Takafumi; Watanabe, Sachiko; Higaki, Jitsuo

doi:10.1291/hypres.28.797

Cited by 23 publications

(31 citation statements)

References 40 publications

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“…Hypertensive patients with left ventricular hypertrophy had a higher stiffness β and lower CSDC and Vd/Vs than normotensive subjects (17). We have also reported a negative correlation between Vd/Vs and the severity of asymptomatic cerebral deep gray matter lesions, "etat crible," estimated by brain MRI (29). In the present study, we found a significant correlation between CAVI and stiffness β, CSDC, and Vd/Vs, in addition to IMT, suggesting that CAVI may serve as a useful clinical marker of arteriosclerosis and atherosclerosis.…”

Section: Discussionsupporting

confidence: 54%

Relationship between Cardio-Ankle Vascular Index (CAVI) and Carotid Atherosclerosis in Patients with Essential Hypertension

et al. 2007

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Section: Discussionsupporting

confidence: 54%

Relationship between Cardio-Ankle Vascular Index (CAVI) and Carotid Atherosclerosis in Patients with Essential Hypertension

et al. 2007

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“…The most frequently tested variable has been IMT, which was found increased in association to brain MRI lesions [9] [18] [26]. Nevertheless, this association was not encountered very recently by Heliopoulos et al in a sample of 52 hypertensive patients (mean age 71.4 years), nor in the present study.…”

Section: Discussioncontrasting

confidence: 53%

“…Changes in macrocirculation can be assessed by high-resolution B-mode ultrasonography. Limited studies have evaluated the relation between WMHs on brain MRI and ultrasound assessments of structural macrocirculation-vessel changes with partly conflicting findings [9]- [12]. Due to the high cost and low availability of MRI studies, the use of carotid Doppler as a potential marker of asymptomatic cerebral damage remains a very attractive option.…”

Section: Introductionmentioning

confidence: 99%

Resistive Cerebral Blood Flow as a Potential Marker of Subclinical Brain Damage in Essential Hypertension

González-García¹,

Hernández-Díaz²,

Quevedo-Sotolongo³

et al. 2014

WJCD

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Introduction: Subclinical brain damage in essential hypertension is more prevalent than cardiovascular or renal impairment; nevertheless, screening for nervous system involvement is difficult due to the low accessibility and high costs of these techniques. Objective: To assess the frequency of silent target organ damage in a cohort of asymptomatic hypertensive patients and to evaluate the potential usefulness of carotid ultrasonographic (US) variables as predictors of subclinical brain damage. Patients and Methods: Thirty four neurologically asymptomatic subjects (mean age 59 years) with essential hypertension were included. Target organ damage was evaluated: degree of hypertensive retinopathy, heart, kidney and brain. Structural and hemodynamical carotid Doppler US parameters were also investigated. Results: The brain was the most frequently affected target organ (70.6%), followed by the heart (67.9%) and kidney (58.6%). Carotid US parameters showed no association of intima media thickness with brain MRI results; nevertheless, decreased diastolic flow velocity and increased resistive index pointed to a resistive carotid flow pattern in patients with classical brain MRI lesions and predicted subclinical lesions with a sensitivity of 70% and 74% and a specificity of 72% and 80% respectively. Conclusions: This study supports previous findings that place the brain as the most frequently affected target organ in essential hypertensive patients and sheds more light on the potential usefulness of carotid structure and hemodynamics as imaging biomarkers of subclinical brain lesions. S. González-García et al. 170 Keywords Subclinical Brain Damage, Essential Hypertension, Carotid Doppler

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“…Plaque was defined as the presence of wall thickening of 50% or greater than the thickness of the surrounding wall, with a minimum absolute thickness of 1.1 mm. [17][18][19] Observation of plaque was performed from 4.5 cm proximal to 1.5 cm distal to the bifurcation. Twodimensional guided M-mode tracings of the bilateral CCA at a point 2 cm proximal to the bulb from the anterior, lateral and posterior approaches were recorded with an electrocardiogram, 18 and the internal diameters of the CCA at end-diastole (Dd) and peak-systole (Ds) were measured in three cycles and averaged.…”

Section: Evaluation Of Carotid Atherosclerosismentioning

confidence: 99%

“…[17][18][19] Observation of plaque was performed from 4.5 cm proximal to 1.5 cm distal to the bifurcation. Twodimensional guided M-mode tracings of the bilateral CCA at a point 2 cm proximal to the bulb from the anterior, lateral and posterior approaches were recorded with an electrocardiogram, 18 and the internal diameters of the CCA at end-diastole (Dd) and peak-systole (Ds) were measured in three cycles and averaged. 19 Axial resolution of the ultrasonography system was 0.1 mm.…”

Section: Evaluation Of Carotid Atherosclerosismentioning

confidence: 99%

Silent cerebral microbleeds associated with arterial stiffness in an apparently healthy subject

et al. 2009

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Silent cerebral microbleeds (MBs) are a common finding in stroke patients, especially those with intracerebral hemorrhage, and are thought to be a marker of future cerebral hemorrhage. Clinically, two distinct forms of MBs have been documented, those observed with either or both stroke or small vessel disease (SVD) and those associated with cerebral amyloid angiopathy. We investigated a possible association between MBs and arterial stiffness in a general population. Subjects were 443 apparently healthy individuals with a mean age of 67.1 ± 8.1 years. The presence of MBs, lacunar infarcts and periventricular hyperintensity (PVH) was determined by 3-tesla magnetic resonance imaging. Carotid intima-media thickness (IMT) was measured by ultrasonography. Arterial stiffness was evaluated by brachial-to-ankle pulse wave velocity (baPWV), and the Framingham stroke risk score (FSRS) was obtained as an integrated cerebrovascular risk factor. The prevalence of MBs was 5.0%. Both baPWV and FSRS were significantly higher in subjects with MBs (1820 ± 308 vs. 1645 ± 325 cm/s, P¼0.014 and 12.1 ± 8.6 vs. 8.9 ± 7.5%, P¼0.047, respectively). Odds ratio of a high baPWV, defined as X1500 cm/s, for the presence of MBs was 6.05 even after correction for confounding parameters, including age and hypertension. This association with high baPWV remained irrespective of MBs location, whether strictly located in the lobes or in the basal ganglia and infratentorial regions. These findings indicate an association between arterial stiffness and the presence of MBs. Assessment of arterial stiffness may be useful in identifying subjects at high risk for the presence of MBs.

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Association between Carotid Hemodynamics and Asymptomatic White and Gray Matter Lesions in Patients with Essential Hypertension

Cited by 23 publications

References 40 publications

Relationship between Cardio-Ankle Vascular Index (CAVI) and Carotid Atherosclerosis in Patients with Essential Hypertension

Relationship between Cardio-Ankle Vascular Index (CAVI) and Carotid Atherosclerosis in Patients with Essential Hypertension

Resistive Cerebral Blood Flow as a Potential Marker of Subclinical Brain Damage in Essential Hypertension

Silent cerebral microbleeds associated with arterial stiffness in an apparently healthy subject

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