Noninvasive investigation of autonomic activity after carotid stenting or carotid endarterectomy

Abstract

These preliminary data suggest that CAS is associated with parasympathetic predominance postoperatively and may probably explain the lower systolic arterial pressure observed after CAS.

Effects of Chronic Baroreceptor Stimulation on the Autonomic Cardiovascular Regulation in Patients With Drug-Resistant Arterial Hypertension

“…Carotid arterial stenting was associated with a short-term parasympathetic predominance that was associated with decreased BP. [25][26][27] This may be attributed to stimulation of the baroreceptors through stretching of the carotid sinus by angioplasty and stent deployment. In contrast, HRV measurements in patients after carotid endarterectomy showed an increased sympathetic and a decreased vagal activity during the first 4 days postprocedure compared with baseline.…”

Baroreceptor sensitivity and diabetes mellitus

“…As a matter of fact, atherosclerosis is both premature and accelerated in diabetic patients [41,42]. Carotid atherosclerosis has been associated with depressed BRS [43][44][45][46]. In another study in type 2 DM patients, carotid atherosclerosis was linked to impaired BRS and CAN [47].…”

Comparing cardiovascular load by heart rate variability (HRV) including pNNxx parameters with ratings of perceived medical intervention load (PMIL) in patients undergoing carotid endarterectomy or carotid artery stenting

“…Moreover, randomization wouldn't have been feasible with regard to the best medical treatment for each patient. Secondly, concomitant medications might have had an influence on HRV, as also discussed by Yakhou, et al [22]. In fact, all patients suffered from medical conditions necessitating drugs (e.g.…”

“…Most studies measuring HRV in the context of CEA or CAS concentrated on their influence on the carotid baroreflex function and therewith postoperative hemodynamic instability [18][19][20][21][22]. Sigaudo-Roussel, et al [21] focused on deterioration in carotid baroreflex during and after CEA under general anesthesia (GA) and demonstrated a temporary sympathetic predominance (LF nu > HF nu) and reduced TP until six weeks afterwards.…”

“…Sigaudo-Roussel, et al [21] focused on deterioration in carotid baroreflex during and after CEA under general anesthesia (GA) and demonstrated a temporary sympathetic predominance (LF nu > HF nu) and reduced TP until six weeks afterwards. Investigating both CEA and CAS, Yakhou, et al [22] demonstrated parasympathetic predominance (increased HF nu, decreased LF/HF ratio) 8 and 24 hours after CAS and no change after CEA in 20 patients. Starting from similar baseline-values in the two groups, they interpreted the changes as activation of the baroreflex after CAS.…”