Intima-media thickness of the common femoral artery as a marker of leg ulceration in sickle cell disease patients

Ayoola, Oluwagbemiga Oluwole; Bolarinwa, Rahman A.; Onakpoya, Uvie Ufuoma; Adedeji, Tewogbade Adeoye; Onwuka, Chidiogo Chukwunweike; Idowu, Bukunmi Michael

doi:10.1182/bloodadvances.2018023267

Cited by 12 publications

(11 citation statements)

References 37 publications

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“…35 In Nigerians with hypertension, carotid and femoral thickness increased significantly compared to healthy subjects and the thick femoral IMT was one of the pinpoints of atherosclerosis. 36 Our results showed that the percentage of femoral atherosclerosis was significantly higher in patients with high 24-h MAUS and low eGFR when compared with those with normal eGFR and negative 24-h MAUS. Theoretically, microalbuminuria and chronic kidney diseases are the risks of cardiovascular disease and contributed to the abnormal changes of endothelial function.…”

Section: The Prevalence Of Abnormal Femoral Arterial Intima-media Thimentioning

confidence: 44%

<p>The Association Between Femoral Artery Intima-Media Thickness and Serum Glucagon-Like Peptide-1 Levels Among Newly Diagnosed Patients with Type 2 Diabetes Mellitus</p>

Nguyen

et al. 2020

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Introduction: Endothelium dysfunction and decrease of incretin effects occur early in type 2 diabetes mellitus and these changes contribute to diabetic cardiovascular complications such as atherosclerosis, thick intima-media, coronary, and peripheral arterial diseases. In patients with diabetes, the femoral artery is a site of a high incidence of injury in peripheral vascular diseases, and atherosclerotic changes may appear earlier in the femoral artery compared to the carotid artery. This study was conducted to determine the prevalence of increased femoral artery intima-media thickness (IMT) and atherosclerotic plaque and their correlation with serum glucagon-like peptide-1 (GLP-1) levels in newly-diagnosed patients with type 2 diabetes mellitus. Materials and Methods: A cross-sectional study was conducted on 332 patients with nT2D in the National Endocrinology Hospital, Vietnam from January 2015 to May 2018. IMT was measured by Doppler ultrasound and GLP-1 by enzyme-linked immunosorbent assay (ELISA). All data were analyzed with SPSS version 26 for Windows (SPSS Inc, Chicago, IL). Results: Prevalence of thick femoral artery IMT and atherosclerotic plaque was 38.2 and 22.3%, respectively. There was a relationship between IMT and age, waist to hip ratio (WHR), systolic blood pressure (SBP), diastolic blood pressure (DBP), fasting GLP-1, high sensitive CRP (hsCRP) and 24-hour microalbuminuria secretion (24-h MAUS). The fasting serum GLP-1 (fGLP-1) levels were reduced significantly in patients with thickness and atherosclerosis femoral artery (p = 0.001). After adjusting with other related factors, namely, DBP and estimated glomerular filtration rate (eGFR), whilst hsCRP and 24-h MAUS showed a significantly positive correlation to IMT (Standardized B and p of 0.242, 0.004 and 0.178, 0.043, respectively), fGLP-1 showed a significantly negative correlation to IMT (Standardized B = −0.288, p = 0.001). Conclusion: Among n2TD, the percentage for femoral artery thick IMT and atherosclerosis was 38.2% and 22.3% respectively, and serum GLP-1 was negatively correlated with thick IMT and atherosclerosis.

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Section: The Prevalence Of Abnormal Femoral Arterial Intima-media Thimentioning

confidence: 44%

<p>The Association Between Femoral Artery Intima-Media Thickness and Serum Glucagon-Like Peptide-1 Levels Among Newly Diagnosed Patients with Type 2 Diabetes Mellitus</p>

Nguyen

et al. 2020

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“…SCD is associated with a progressive vasculopathy that has been demonstrated in several vascular territories, including the cerebral circulation where it is implicated in predisposition to stroke . It has also been implicated in the development of pulmonary hypertension, leg ulceration, and priapism . The blood velocity changes of the celiac and SMAs seen in this case series on Doppler ultrasonography are probably a result of this vasculopathy.…”

Section: Discussionmentioning

confidence: 62%

“…8 It has also been implicated in the development of pulmonary hypertension, leg ulceration, and priapism. 9,25 The blood velocity changes of the celiac and SMAs seen in this case series on Doppler ultrasonography are probably a result of this vasculopathy.…”

Section: Case Seriesmentioning

confidence: 76%

Doppler ultrasonographic evaluation of celiac and mesenteric arteries in subjects with sickle cell disease

Ayoola

Bolarinwa

Onakpoya

et al. 2019

J of Clinical Ultrasound

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Vasculopathy, as occurring in sickle cell disease (SCD), can affect celiac and mesenteric arteries and result in stenosis, with elevated peak systolic velocity (PSV) on Doppler ultrasonography. In six subjects with confirmed SCD in steady state, routine Doppler ultrasonographic examination discovered features of celiac artery (CA) or superior mesenteric artery (SMA) stenosis with CA PSV >200 cm/s (median = 222.8 cm/s; range = 201.5‐427.1 cm/s) and/or SMA PSV >275 cm/s (median 183.2 cm/s; range = 87.8‐289.3 cm/s). Among the six subjects, five had elevated soluble P‐selectin values (median 72.55 ng/mL), while all six (100%) had elevated cystatin C levels (median 4.15 mg/L). Peripheral oxygen saturation was suboptimal in five subjects. All subjects had low hemoglobin concentration levels (median 8.5 g/dL) while four had elevated white blood cell count. Although vaso‐occlusive crises result from microvessel occlusion, these findings at the macrovascular level suggest that SCD patients may also be vulnerable to mesenteric ischemic injury, especially in the setting of anemic heart failure from hemolysis.

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“…ED has been implicated in the chronic arterial vasculopathy seen in patients with SCD, which is said to be responsible for diverse multiorgan pathologies (18). Ultrasonography has proven to be useful in assessing vasculopathic changes of the cerebral arteries (19,20), renal arteries (21,22), and femoral arteries (23) in SCD. In contrast to these arteries, which reflect changes to localized regions of the body, FMD of the brachial artery has the advantage of giving an overview of the overall vascular health of the body.…”

Section: Discussionmentioning

confidence: 99%

“…Sherwood et al (46) confirmed that patients with SCD had reduced erythropoietin levels in comparison with a control population. Tissue ischemia and infarction resulting from vascular occlusion in SCD are primarily due to the microvascular obstruction by SRBC, although vasculopathic changes in larger vessels are also known to affect the kidneys ( Figure 2) (23,47,48). Circulating microparticles found in patients with end stage renal failure have been associated with ED, which is a significant determinant of cardiovascular risk (49).…”

Section: Discussionmentioning

confidence: 99%

Association between Endothelial Dysfunction, Biomarkers of Renal Function, and Disease Severity in Sickle Cell Disease

et al. 2020

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Background Endothelial dysfunction (ED), as ascertained by brachial artery flow-mediated dilation (FMD), is a known feature of sickle cell disease (SCD), which is present both in crisis and in steady state. The assessment of FMD was introduced to examine the vasodilator function. Our objective was to establish the relationship between ED determined by FMD, biomarkers of renal dysfunction, and biomarkers of disease severity in SCD subjects asymptomatic of renal disease. Methods We enrolled 44 patients with homozygous SCD in steady state and 33 age-and sex-matched controls between 2013 and 2014 in a tropical tertiary hospital. Ultrasonographic FMD of the right brachial artery, renal arterial Doppler, complete blood count, creatinine, fetal hemoglobin, soluble P-selectin, and cystatin C (Cys-C) levels were determined. Using the median FMD value of the control group, the SCD subjects were further classified into two groups for comparison. Results The median FMD in SCD subjects of 3.44 (IQR, 0.00-7.08) was significantly lower than that of controls, which was 5.35 (IQR, 3.60-6.78; P50.04). There was negative correlation between FMD and Cys-C levels (r520.372; P50.01) along with renal artery resistivity index (RARI; r520.307; P50.04) in SCD subjects. Additionally, Cys-C level was significantly higher in SCD subjects with FMD,5.35. Conclusions Brachial artery FMD was significantly lower in SCD subjects compared with a control group. Cys-C and RARI show a negative correlation with FMD, indicating that renal function is related to ED in SCD.

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Intima-media thickness of the common femoral artery as a marker of leg ulceration in sickle cell disease patients

Cited by 12 publications

References 37 publications

<p>The Association Between Femoral Artery Intima-Media Thickness and Serum Glucagon-Like Peptide-1 Levels Among Newly Diagnosed Patients with Type 2 Diabetes Mellitus</p>

<p>The Association Between Femoral Artery Intima-Media Thickness and Serum Glucagon-Like Peptide-1 Levels Among Newly Diagnosed Patients with Type 2 Diabetes Mellitus</p>

Doppler ultrasonographic evaluation of celiac and mesenteric arteries in subjects with sickle cell disease

Association between Endothelial Dysfunction, Biomarkers of Renal Function, and Disease Severity in Sickle Cell Disease

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