<p>Carotid artery calcification score and its association with cognitive impairment</p>

Abstract

PurposeTo retrospectively investigate the possible association between carotid artery calcification score (CS) and cognitive impairment in carotid artery stenosis (CAS) patients.Patients and methodsCarotid artery was measured in 102 patients with cervical carotid arteries using Color Doppler ultrasound, multi-detector row spiral CT angiography and MRI scanning. Correlation analysis between CSs obtained by MD CT and cognitive scores was performed, and the correlation between CSs and vascular stenosis degree and MRI-measured plaque histological (lipid-rich necrotic nucleus [LRNC], intraplaque hemorrhage and fibrous cap surface rupture) and morphological parameters (lumen area [LA], wall area [WA], total area of blood vessels [TVA], plaque burden [PB]) was analyzed. Follow-up review analysis was conducted on 38 postoperative patients.ResultsSignificant negative correlation was discovered between CS value and cognitive scores in CAS patients (R=−0.359, P<0.001), which did not exist in postoperative patients (P=0.348); CS value also showed significant correlation with WA (R=0.521, P=0.042), TVA (R=0.215, P=0.017) and PB (R=0.237, P=0.003) and had a certain predictive value for the occurrence probability of carotid plaque LRNC (P=0.029, AUC =0.780) in preoperative patients.ConclusionCarotid artery CSs have significant correlation with cognitive scores, which could be used as risk factor for early screening of cognitive impairment in CAS patients. The possible mechanism may be related to the calcification impact on the plaque burden.

Doppler Ultrasound Monitoring of Echogenicity in Asymptomatic Subcritical Carotid Stenosis and Assessment of Response to Oral Supplementation of Vitamin K2 (PLAK2 Randomized Controlled Trial)

“…On the background of a linear relationship between plaque stability and echogenicity, we observed that a minority of patients treated with standard therapy showed a reduction in plaque echogenicity. This finding correlates with the ambiguous role of vascular calcification, that may represent an element of vulnerability in only a minority of patients [ 9 , 10 , 11 , 12 , 26 , 38 ]. In patients with abnormal upregulated calcification, a tailored targeted molecular therapy oriented toward the calcification process, such as vitamin K2 supplementation, may be effective.…”

“…A recent meta-analysis on the effect of statin therapy on the plaque composition showed a positive increase in the plaque echogenicity up to 35% in 12 months, even if the role of calcium content is not completely understood and still controversial [ 8 ]. Some authors state that it is a stabilizing factor, whereas others consider it a predictor of plaque vulnerability, as it has been recently associated to the presence of cerebral ischemic lesions and cognitive impairment [ 9 , 10 ]. Vitamin K2 (menaquinones) acts as cofactor in the post-translational modification of the gamma-glutamyl carboxylation of glutamate residues in matrix Gla-protein, enhancing its inhibitor role on vascular calcification.…”

“…Even if GSM value it is not widespread utilized, due to the laborious post-processing analysis, it has a potential role in monitoring plaque composition, in giving a reliable plaque risk stratification and in evaluating and tailoring pharmacological therapy. Although statin therapy in carotid stenosis leads to an overall increase in plaque echogenicity, interpreted as a stability factor [ 8 ], recent studies have shown a correlation between carotid calcification and cerebral ischemic lesions contributing to cognitive impairment and mortality [ 9 , 10 , 11 , 12 ]. Based on the plaque composition evaluation with doppler US and GSM application we monitored asymptomatic subcritical carotid artery stenosis on standard therapy and evaluated the effects of oral supplementation of vitamin K2 as a modulating factor in vascular calcification in 12 months trial [ 13 , 14 , 15 , 16 , 17 , 18 , 19 ].…”

“Stroke-Stop” Formula: A Tool for Risk Index Determination in Development of Acute Cerebrovascular Disease in Patients with Asymptomatic Internal Carotid Artery Stenosis

“…The combination of three factors -stenosis, ulceration of the atherosclerotic plaque and the in ammatory process within it -is one of the leading mechanisms of embologenicity as well as the development of stroke [21,22]. This mechanism is not taken into consideration by the classical approach to determining the indications for carotid endarterectomy where the main criterion is the degree of ICA stenosis (50% in symptomatic patients and 70% in asymptomatic patients).…”

Maladaptive neuropathological syndrome of blood vessel aging

“…В научной литературе обсуждается вопрос о том, что ускоренное старение КС связано с их кальцификацией, что непосредственно влияет на высшие психические функции человека. Так, например, кальцификация сонной артерии имеет значительную корреляцию с когнитивными нарушениями, а внутричерепная кальцификация сосудов связана с обширными изменениями белого вещества головного мозга и является причиной выраженных психоневрологических симптомов [23][24][25]. Тем не менее, имеются данные о том, что биологический возраст артерий (жесткость и эластичность) взаимосвязан с факторами риска атеротромбоза.…”