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Common Carotid Artery (common + carotid_artery)
Kinds of Common Carotid Artery Terms modified by Common Carotid Artery Selected AbstractsAssessment of Carotid Compliance Using Real Time Vascular Ultrasound Image Analysis in Marfan SyndromeECHOCARDIOGRAPHY, Issue 4 2009Anatoli Kiotsekoglou M.D. Background: Fibrillin-1 deficiency, dysregulated cytokine transforming growth factor-,, and increased collagen deposition related to fibrillin-1 gene mutations could predispose to impaired carotid compliance (CC) in Marfan syndrome (MFS). We sought to detect any alterations in CC using the vascular image analysis system (VIA). Methods and Results: Thirty-two MFS patients, 20 men and 12 women (mean age 34.2 ± 12.05 years), and 29 controls matched for age, sex, and body surface area (BSA) were recruited. The entire length of each carotid system was initially scanned longitudinally using a 14 MHz linear transducer. Then, a stereotactic clamp held the transducer in contact with the carotid artery. Arterial diameter changes during the cardiac cycle were recorded for 1 minute from both right (RCCA) and left common carotid arteries (LCCA) separately using the VIA system. RCCA and LCCA compliance and distensibility measurements were significantly reduced in MFS patients when compared to controls, P < 0.05. RCCA and LCCA intima-media thickness did not differ between patients and controls, P > 0.05. MFS diagnosis and age were associated with reduced CC in both carotid arteries after adjusting for variables such as, sex, BSA, heart rate, beta-blockade, intima-media thickness, and aortic root size. Conclusions: Our findings showed a reduction in CC in adult patients with MFS. This could be attributed to fibrillin-1 deficiency resulting in structural abnormalities in the carotid arterial wall. [source] The Effect of Angiotensin II Type-1 Receptor Gene Polymorphisms on Doppler Blood Flow Parameters of Carotid and Brachial Arteries in Patients with Myocardial InfarctionECHOCARDIOGRAPHY, Issue 7 2006Onder Ozturk M.D. Background: Genetic influence on Doppler blood flow parameters of carotid and brachial arteries (BA) is uncertain. We investigated the relationship between the angiotensin II type-1 receptor (AT1R) gene polymorphism and the blood flow characteristics of common carotid arteries (CCA) and BA by color Doppler ultrasound (CDUS) in patients with a first anterior acute myocardial infarction (AMI). Methods and Results: Sixty-seven patients (15 women and 52 men), aged 25,77 years, with anterior AMI were studied. The AT1R genotypes were established. Based on the polymorphism of the AT1R, they were classified into three groups: AT1R AA genotype (Group1, n = 42 patients), AT1R AC genotype (Group 2, n = 17 patients), and AT1R CC genotype (Group 3, n = 8 patients). Peak-systolic velocity (PSV) and end-diastolic velocity (EDV) of right and left CCA, PSV of right BA, and intimal-medial thickness (IMT) of both CCA were measured by CDUS. All results evaluated statistically. The AT1R genotypes were distributed as follows: 63% AA, 25% AC, and 12% CC. PSV of BA and both CCA were higher in patients with CC and AC than AA (P < 0.05). Also, IMT of both CCA were also higher in the same groups (P < 0.05). Conclusions: Our results suggest that AT1R gene polymorphism influences Doppler blood flow parameters of both BA and CCA, and IMT of CCA. Although further studies are required. [source] Uremic hyperhomocysteinemia: A randomized trial of folate treatment for the prevention of cardiovascular eventsHEMODIALYSIS INTERNATIONAL, Issue 2 2007Areuza C. A. VIANNA Abstract Homocysteine is a risk factor for atherosclerosis in the general population, and serum homocysteine levels are almost universally elevated in chronic renal failure patients. When such patients are treated with dialysis, cardiovascular disease accounts for more than 50% of their mortality, which, in some proportion, may be pathophysiologically related to the elevated serum homocysteine levels. From April 2003 to March 2005, we conducted a 2-year, double-blind, randomized, placebo-controlled trial of 186 patients with end-stage kidney disease due to any cause, who were older than 18 years and stable on hemodialysis. Patients were assigned to receive either oral folic acid 10 mg 3 times a week immediately after every dialysis session under nurse supervision or an identical-appearing placebo for the entire study. On admission, plasma total homocysteine (tHcy) levels were above 13.9 ,mol/L in 96.7% of patients (median 25.0 ,mol/L, range 9.3,104.0 ,mol/L). In the placebo group, tHcy levels remained elevated at 6, 12, and 24 months, while oral folate significantly decreased tHcy to a median value of 10.5 (2.8,20.3) ,mol/L, (p<0.01). During the study, 38 patients (folic acid group 17 vs. placebo group 21; p=0.47) died from cardiovascular disease. Kaplan,Meier life table analysis dealing with the incidence of cardiovascular events, both fatal and nonfatal (myocardial infarction, arrhythmias, angina, heart failure, cerebrovascular accident), showed that 2 years of folic acid treatment and the lowering of the homocysteine blood levels had no effect on cardiovascular events (p=0.41; hazard ratio 1.24, 95% CI 0.74,2.10). However, the carotid artery intima-media wall thickness measured in a blinded fashion decreased from 1.94 ± 0.59 mm to 1.67 ± 0.38 mm (p<0.01) after 2 years of folate therapy. In this short-term study of uremic patients, 2 years of folic acid supplementation normalized the tHcy blood levels in 92.3% of patients but did not change the incidence of cardiovascular events compared with the control group. However, ultrasonography of the common carotid arteries performed at entry and 24 months later showed a significant decrease in intima-media thickness with folate supplementation. This suggests that early folate supplementation may benefit patients with chronic renal failure by preventing cardiovascular deterioration. [source] Gingival health status in renal transplant recipients: relationship between systemic inflammation and atherosclerosisINTERNATIONAL JOURNAL OF CLINICAL PRACTICE, Issue 4 2007G. Genctoy Summary Cardiovascular disease (CVD) is the leading cause of mortality in renal transplant recipients (RTR). Systemic and periodontal inflammation has been suggested to have a possible role in the development of atherosclerosis. In the present study, we aimed to investigate the relationship between gingival health status, inflammation and atherosclerosis in RTRs. Eighty-three RTR (50 male, 33 female) were enrolled in the study. Routine biochemical analyses, serum lipoproteins, C-reactive protein, fibrinogen, homocystein, parathyroid hormone (PTH) and cyclosporin A (CsA) trough levels were studied. All patients had 24-h ambulatory blood pressure monitoring and B-mode ultrasound of the common carotid arteries. Gingival status was evaluated by the Löe and Silness gingival index (GI). Mean GI value was 2.3 ± 0.5. Fifty patients (60.3%) had GI value , 2.1 (severe gingivitis; group A). Thirty-three patients (39.7%) had GI value < 2.1 (no or moderate gingivitis; group B). Age, carotid intima-media thickness (CIMT) and mean time on dialysis before transplantation were significantly higher in group A than in B. Systemic inflammation markers were not different between group A and group B. Mean CIMT was positively correlated with GI (r = 0.425; p = 0.001) and negatively correlated with high-density lipoprotein cholesterol (r = ,0.256; p = 0.023). After the correction for confounding variables, mean CIMT was still significantly correlated with GI (r = 0.376, p = 0.02). In RTR, gingival inflammation seems to be associated with CIMT in the absence of systemic inflammation. Thus, gingivitis may, in part, play a role in the development of systemic atherosclerosis without causing any aggravation in systemic inflammatory response. [source] Color and power Doppler sonography of extracranial and intracranial arteries in moyamoya diseaseJOURNAL OF CLINICAL ULTRASOUND, Issue 2 2006Li-Tao Ruan MD Abstract Purpose: To study the hemodynamic characteristics of moyamoya disease with color Doppler (CD) and power Doppler (PD) sonography. Methods: The hemodynamic parameters of intracranial and extracranial arteries from 17 patients with moyamoya disease confirmed via digital subtraction angiography and 30 healthy controls were studied with conventional and transcranial CD and PD. Results: The moyamoya vessels were detected as scattered color Doppler signal with low velocity and a low resistance index (RI) at the base of the brain in 10 of the 17 patients. The RI of the common carotid arteries and the internal carotid arteries of the patients was significantly higher, whereas the peak velocity was lower than in controls. The posterior carotid arteries were more frequently involved in children (43.8%) than in adults (5.6%). Conclusions: Transcranial CD and PD can be used to demonstrate the stenosis and occlusion of intracranial arteries and the abnormal vascular network at the base of the brain in most cases. Combined with the hemodynamic characteristics of extracranial arteries and the symptoms of the patients, an accurate diagnosis of moyamoya disease could be made in the majority of cases using PD. © 2006 Wiley Periodicals, Inc. J Clin Ultrasound 34:60,69, 2006 [source] The neuronal apoptotic death in global cerebral ischemia in gerbil: Important role for sodium channel modulator,JOURNAL OF NEUROSCIENCE RESEARCH, Issue 6 2009Manoja Kumar Brahma Abstract Global ischemia was induced in gerbil by bilateral occlusion of the common carotid arteries for 5 min. Sodium ionophore monensin or sodium channel blocker tetrodotoxin (TTX) was administered at doses of 10 ,g/kg, i.p., 30 min before ischemia induction; the dose was repeated after 22 hr. Subsequently, brain infarct occurred, determined at 24 hr after occlusion. Large, well-demarcated infarcts were observed in both hemispheres, an important observation because it critically influences the interpretation of the data. Because nitric oxide (NO) production is thought to be related to ischemic neuronal damage, we examined increases in Ca2+ influx, which lead to the activation of nitric oxide synthase (NOS). Then we evaluated the contributions of neuronal NOS, endothelial NOS, and inducible NOS to NO production in brain cryosections. The cytosolic release of apoptogenic molecules like cytochrome c and p53 were confirmed after 24 hr of reflow. TUNEL (terminal deoxynucleotidyl transferase dUTP nick-end labeling) labeling detected the apoptotic cells, which were confirmed in neuron-rich cell populations. After 24 hr, all the ischemic changes were amplified by monensin and significantly attenuated by TTX treatment. Additionally, the nesting behavior and histological outcomes were examined after 7 day of reflow. The neuronal damage in the hippocampal area and significant decrease in nesting scores were observed with monensin treatment and reduced by TTX pretreatment after day 7 of reflow. To our knowledge, this report is the first to highlight the involvement of the voltage-sensitive Na+ channel in possibly regulating in part NO system and apoptosis in a cytochrome c,dependent manner in global ischemia in the gerbil, and thus warrants further investigation. © 2008 Wiley-Liss, Inc. [source] Neuroprotective mechanisms of curcumin against cerebral ischemia-induced neuronal apoptosis and behavioral deficitsJOURNAL OF NEUROSCIENCE RESEARCH, Issue 1 2005Qun Wang Abstract Increased oxidative stress has been regarded as an important underlying cause for neuronal damage induced by cerebral ischemia/reperfusion (I/R) injury. In recent years, there has been increasing interest in investigating polyphenols from botanical source for possible neuroprotective effects against neurodegenerative diseases. In this study, we investigated the mechanisms underlying the neuroprotective effects of curcumin, a potent polyphenol antioxidant enriched in tumeric. Global cerebral ischemia was induced in Mongolian gerbils by transient occlusion of the common carotid arteries. Histochemical analysis indicated extensive neuronal death together with increased reactive astrocytes and microglial cells in the hippocampal CA1 area at 4 days after I/R. These ischemic changes were preceded by a rapid increase in lipid peroxidation and followed by decrease in mitochondrial membrane potential, increased cytochrome c release, and subsequently caspase-3 activation and apoptosis. Administration of curcumin by i.p. injections (30 mg/kg body wt) or by supplementation to the AIN76 diet (2.0 g/kg diet) for 2 months significantly attenuated ischemia-induced neuronal death as well as glial activation. Curcumin administration also decreased lipid peroxidation, mitochondrial dysfunction, and the apoptotic indices. The biochemical changes resulting from curcumin also correlated well with its ability to ameliorate the changes in locomotor activity induced by I/R. Bioavailability study indicated a rapid increase in curcumin in plasma and brain within 1 hr after treatment. Together, these findings attribute the neuroprotective effect of curcumin against I/R-induced neuronal damage to its antioxidant capacity in reducing oxidative stress and the signaling cascade leading to apoptotic cell death. © 2005 Wiley-Liss, Inc. [source] Human plasminogen kringle 1,5 reduces atherosclerosis and neointima formation in mice by suppressing the inflammatory signaling pathwayJOURNAL OF THROMBOSIS AND HAEMOSTASIS, Issue 1 2010P. C. CHANG Summary.,Background:,Activation of vascular endothelial cells plays an important role in atherogenesis and plaque instability. Recent research has demonstrated that late-stage inhibition of plaque angiogenesis by angiostatin (kringle 1,4) reduces macrophage accumulation and slows the progression of advanced atherosclerosis. Kringle 1,5 (K1,5) is a variant of angiostatin that contains the first five kringle domains of plasminogen. Objective: To investigate whether K1,5 has an inhibitory effect on early-stage atherosclerosis, using the apolipoprotein E (ApoE)-deficient mouse model and a carotid artery ligation model. Methods: ApoE-deficient mice received K1,5 treatment for 4 weeks, and the severity of aortic atherosclerosis was measured. In the ligation model, the left common carotid arteries of C57BL/6 mice were ligated near the carotid bifurcation, and the mice received K1,5 for 4 weeks. Human umbilical vein endothelial cells were pretreated with K1,5 before tumor necrosis factor-, (TNF-,) treatment to explore the anti-inflammatory effect of K1,5. Results: The areas of the lesion in the aortas of ApoE-deficient mice that received K1,5 treatment were notably decreased, and the formation of carotid neointima in the C57BL/6 mice was decreased by treatment with K1,5. Expression of TNF-,-induced intercellular adhesion molecule-1 and vascular cell adhesion molecule-1 was inhibited by K1,5 treatment, possibly via downregulation of translocation of nuclear factor-,B and expression of reactive oxygen species. Conclusions: K1,5 reduced atherosclerosis and neointima formation in mice, possibly through inhibition of intercellular adhesion molecule-1 and vascular cell adhesion molecule-1 expression in endothelial cells. [source] The Anatomy of the Arterial Supply of the Thoracic Limb of the Porcupine (Hystrix cristata)ANATOMIA, HISTOLOGIA, EMBRYOLOGIA, Issue 5 2001Sadik Yilmaz The aim of this study was to investigate the anatomy of the arterial supply and branches of the thoracic limb of the porcupine. With this aim, five (three male and two female) adult porcupines were used. The vascular tree of the thoracic limb was injected through the common carotid arteries with coloured latex. The a. thoracica externa arose from the a. axillaris at the level of the fourth rib. It divided into two branches and went to the m. cutaneus trunci and the m. pectoralis ascendens. The a. subscapularis came off the a. thoracodorsalis. Later, the a. circumflexa humeri caudalis et cranialis, the three muscular branches and the a. circumflexa scapulae arose from the a. subscapularis. The a. profunda brachii arose together with the a. bicipitalis from the same truncus. The a. collateralis ulnaris left from the a. brachialis independently. Rete carpi dorsale was formed by the a. radialis, the r. carpeus dorsalis of the a. collateralis ulnaris and the a. interossea caudalis. Arcus palmaris profundus was formed by the r. profundus of the a. interossea caudalis and the r. palmaris profundus of the a. radialis. In conclusion, despite a partial resemblance to that in the rat, the distribution of the thoracic limb arteries in the porcupine was found to be completely different from that of other mammals. These findings represent, to our knowledge, the first study on the distribution of thoracic limb arteries in the porcupine. [source] Lymphopenia is a risk factor in the progression of carotid intima-media thickness in juvenile-onset systemic lupus erythematosusARTHRITIS & RHEUMATISM, Issue 12 2009Yu-Lin Huang Objective To characterize the atherosclerotic risk factors in the progression of subclinical atherosclerosis in patients with juvenile-onset systemic lupus erythematosus (SLE). Methods This was a longitudinal study of 76 patients with juvenile-onset SLE. Carotid arteries were evaluated using ultrasonography at baseline and at followup visits at 6-month intervals over the 6-year study period. Clinical and laboratory parameters, disease activity, treatment, and traditional risk factors for atherosclerosis were evaluated. Data were analyzed using generalized estimating equations. Results The mean ± SD age of the patients at baseline was 15.01 ± 3.48 years and the mean ± SD disease duration was 2.65 ± 2.5 years. The mean ± SD duration of followup was 3.74 ± 1.24 years. The mean ± SD intima-media thickness (IMT) of the common carotid arteries differed significantly between the patient and control (n = 38) groups (0.63 ± 0.08 mm versus 0.54 ± 0.06 mm; P < 0.001). The presence of lymphopenia at diagnosis and at baseline and higher levels of serum creatinine and C-reactive protein at baseline were positively associated with progression of carotid IMT (P = 0.006, P = 0.043, P = 0.037, and P = 0.049, respectively). In multivariate analysis, only lymphopenia at baseline and at diagnosis were consistently associated with progression of IMT (P = 0.012 and P = 0.045, respectively). Conclusion In patients with juvenile-onset SLE, some nontraditional risk factors for the progression of subclinical atherosclerosis were identified. Lymphopenia was the only independent risk factor for the progression of IMT. The pathogenic mechanisms warrant further investigation. [source] Premature atherosclerosis in pediatric systemic lupus erythematosus: Risk factors for increased carotid intima-media thickness in the atherosclerosis prevention in pediatric lupus erythematosus cohort,ARTHRITIS & RHEUMATISM, Issue 5 2009Laura E. Schanberg Objective To evaluate risk factors for subclinical atherosclerosis in a population of patients with pediatric systemic lupus erythematosus (SLE). Methods In a prospective multicenter study, a cohort of 221 patients underwent baseline measurements of carotid intima-media thickness (CIMT) as part of the Atherosclerosis Prevention in Pediatric Lupus Erythematosus (APPLE) trial. SLE disease measures, medications, and traditional risk factors for atherosclerosis were assessed. A standardized protocol was used to assess the thickness of the bilateral common carotid arteries and the mean maximal IMT of 12 segments. Univariable analysis identified potential associations with CIMT, which were examined in multivariable linear regression modeling. Results Based on the mean-mean common or the mean-max CIMT as the dependent variable, univariable analysis showed significant associations of the following variables with increased CIMT: increasing age, longer SLE duration, minority status, higher body mass index (BMI), male sex, increased creatinine clearance, higher lipoprotein(a) level, proteinuria, azathioprine treatment, and prednisone dose. In multivariable modeling, both azathioprine use (P = 0.005 for the mean-mean model and P = 0.102 for the mean-max model) and male sex (P < 0.001) were associated with increases in the mean-max CIMT. A moderate dosage of prednisone (0.15,0.4 mg/kg/day) was associated with decreases in the mean-max CIMT (P = 0.024), while high-dose and low-dose prednisone were associated with increases in the mean-mean common CIMT (P = 0.021) and the mean-max CIMT (P = 0.064), respectively. BMI (P < 0.001) and creatinine clearance (P = 0.031) remained associated with increased mean-mean common CIMT, while increasing age (P < 0.001) and increasing lipoprotein(a) level (P = 0.005) were associated with increased mean-max CIMT. Conclusion Traditional as well as nontraditional risk factors were associated with increased CIMT in this cohort of patients in the APPLE trial. Azathioprine treatment was associated with increased CIMT. The relationship between CIMT and prednisone dose may not be linear. [source] Carotid Intima-Media Thickness and Plaques in Hemodialysis PatientsARTIFICIAL ORGANS, Issue 9 2000Radovan Hojs Abstract: Atherosclerosis is accelerated in hemodialysis patients. Using B-mode ultrasonography, we compared intima-media thickness (IMT) and the prevalence of plaques in the common carotid and internal carotid arteries in 28 randomly selected hemodialysis patients with that in 28 age- and sex-matched normal controls. The IMT values of the common carotid and internal carotid arteries were higher in hemodialysis patients than in controls with more hemodialysis patients having plaques. In hemodialysis patients, there was a relationship between age and IMT in the common carotid arteries, in the area of bifurcation, and in the internal carotid arteries. We found no relationship between IMT and atherosclerotic risk factors or duration of hemodialysis treatment. IMT at all sites correlated with the number of plaques. Age was the only significant determinant for number of plaques. The results indicate that hemodialysis patients showed advanced atherosclerosis in the carotid arteries compared with age- and sex-matched normal subjects. [source] Vascular responses to ,-adrenoceptor subtype-selective agonists with and without endothelium in rat common carotid arteriesAUTONOMIC & AUTACOID PHARMACOLOGY, Issue 1 2001S. Chiba 1 Using the cannula inserting method, vasodilator responses to ,-adrenoceptor agonists (isoprenaline, denopamine and procaterol) were investigated in isolated and perfused rat common carotid arteries. 2 Each ,-adrenoceptor agonist induced a vasodilation in preparations preconstricted by phenylephrine in a dose-related manner. The potencies were in the order of isoprenaline > procaterol >> denopamine. 3 Denopamine-induced dilations were significantly inhibited by 1 nmol betaxolol (a selective ,1 -adrenoceptor antagonist), but it was not influenced by 1 nmol ICI 118,551 (a selective ,2 -adrenoceptor antagonist). On the other hand, procaterol-induced vasodilations were significantly inhibited by 1 nmol ICI 118,551 but not modified by 10 nmol betaxolol. 4 ACh-induced vasodilations disappeared after intraluminal saponin injection to remove endothelium, but procaterol- and denopamine-induced dilations were not modified by removal of the endothelium. 5 Pretreatment with L -NG -nitroarginine methyl ester (L -NAME) readily inhibited ACh-induced vasodilations. However, neither procaterol- or denopamine-induced vasodilation was modified by L -NAME treatment. 6 From these results, it is concluded that in the rat common carotid arteries (1) there are abundant ,2 - and a few ,1 -adrenoceptors, and (2) there is no participation of the endothelium-dependent mechanism in ,-adrenoceptor mediated vasodilations. [source] Comparison of extra-anatomic bypass grafting with angioplasty for atherosclerotic disease of the supra-aortic trunksBRITISH JOURNAL OF SURGERY (NOW INCLUDES EUROPEAN JOURNAL OF SURGERY), Issue 11 2004B. Modarai Background: Symptomatic stenosis of the supra-aortic trunks (subclavian, innominate and common carotid arteries) can be treated by angioplasty/stenting or surgical bypass. The aim of this study was to compare the initial success and outcome of these two types of treatment. Methods: A prospective database was used to collect information on the presentation, initial success, complications and outcome in 76 patients treated in a single centre between 1983 and 2003. Results: Thirty-five surgical extra-anatomic bypasses were performed, 13 carotid to carotid, 14 carotid to subclavian, two carotid to axillary, three axillary to axillary, one subclavian to axillary and two subclavian to subclavian. One graft occluded after 19 years. No limbs were amputated and no patient had a stroke. The secondary patency rate was 97 per cent at a mean follow-up of 5 years. Forty-one angioplasties were attempted, 34 of the left subclavian, six of the right subclavian and one of the innominate artery. Angioplasty for six subclavian occlusions was unsuccessful. Twenty-seven of 33 arteries remained patent at a mean follow-up of 4 years after a successful endovascular procedure. Conclusion: Extra-anatomic bypass for supra-aortic trunk disease has a better patency than angioplasty, with a comparable complication rate. Copyright © 2004 British Journal of Surgery Society Ltd. Published by John Wiley & Sons, Ltd. [source] Improvement of radiation-induced healing delay by etanercept treatment in rat arteriesCANCER SCIENCE, Issue 8 2009Kenji Sugiyama Surgical treatment often causes difficulty in the irradiated field because of delayed wound healing, which is mainly due to vascular dysfunction. To overcome this difficulty, we attempted to accelerate the recovery from clamp injury in irradiated superficial epigastric arteries of rats as a model. Etanercept, a soluble receptor of tumor necrosis factor-,, was administered four times to rats with irradiated arteries before and after clamp injury. Loss of endothelial cells and necrosis of the media in the irradiated arteries continued for more than 1 week after the injury; however, in the rats treated with etanercept, the endothelial cells recovered in the intima, and ,-smooth muscle actin-positive smooth muscle cells recovered in the injured and irradiated arteries. After clamp injury of common carotid arteries that had previously been irradiated, the blood flow in these arteries was visualized by magnetic resonance (MR) angiography. The time-of-flight signal was weakened in the injured and irradiated arteries. This time-of-flight signal was recovered by the etanercept treatment. These findings suggest that etanercept improves the radiation-impaired healing of arteries in rats. (Cancer Sci 2009) [source] Relationship of lipoprotein(a) with intimal medial thickness of the carotid artery in Type 2 diabetic patients in south IndiaDIABETIC MEDICINE, Issue 6 2003K. Velmurugan Abstract Objective The objective of this study was to investigate the association of lipoprotein(a) [Lp(a)] levels with intimal medial thickness (IMT) in Type 2 diabetic patients in south India. Study design We studied 587 consecutive Type 2 diabetic patients at the M.V. Diabetes Specialities Centre, Chennai. The mean age of the study group was 55 ± 10 years and 71.2% were males. IMT of the right common carotid artery was determined using high-resolution B mode ultrasonography. Lp(a) levels were measured using ELISA. Since the frequency distribution of Lp(a) was skewed, Lp(a) values were log transformed and the geometric mean was used for statistical analysis. The tertiles of IMT were determined to analyse the association of Lp(a) and other factors with IMT. Result The mean Lp(a) level in the study patients was 18.9 ± 3.1 mg/dl (geometric mean ± sd) and the mean IMT of the study subjects was 0.93 ± 0.19 mm (mean ± sd). The prevalence of carotid atherosclerosis (defined as IMT > 1.1 mm) among subjects with elevated Lp(a) levels > 20 mg/dl was significantly higher compared with those with Lp(a) levels , 20 mg/dl (26.9% vs. 16.3%, P = 0.003). Lp(a) levels increased with increase in tertiles of IMT (anova, P < 0.05). Pearson correlation analysis of carotid IMT with other cardiovascular risk factors revealed strong correlation of IMT with age (P < 0.0001), duration of diabetes (P < 0.0001), systolic blood pressure (P < 0.0001), diastolic blood pressure (P = 0.006), LDL-cholesterol (P = 0.023), HbA1c (P = 0.017) and Lp(a) (P < 0.0001). Multiple logistic regression analysis showed age (P = 0.010), LDL-cholesterol (P = 0.032) and Lp(a) (P = 0.021) to be associated with carotid atherosclerosis. Conclusion The results suggest that Lp(a) has a strong association with IMT of carotid arteries in Type 2 diabetic subjects in south India. Diabet. Med. 20, 455,461 (2003) [source] Insulin, insulin propeptides and intima-media thickness in the carotid artery in 58-year-old clinically healthy men.DIABETIC MEDICINE, Issue 2 2002Insulin Resistance study (AIR), The Atherosclerosis Abstract Aims To examine the relationship between specific (intact) insulin, insulin propeptides and subclinical atherosclerosis. Methods A cross-sectional study based on a stratified sampling of randomly selected, clinically healthy 58-year-old men (n = 391). Ultrasound examinations of the carotid arteries were performed with measurement of intima-media thickness (IMT) in the common carotid artery and in the carotid artery bulb. Fasting, cross-reacting plasma insulin (RIA), specific (intact) insulin, proinsulin, 32,33 split proinsulin and C-peptide were measured. Results Plasma concentrations of cross-reacting plasma insulin, specific insulin, proinsulin, 32,33 split proinsulin and C-peptide were univariately associated with common carotid artery IMT. Established risk factors such as blood pressure, smoking, apoB, triglycerides, body mass index (BMI), and waist,hip ratio were also related to IMT. After adjustment for smoking, apoB, blood pressure and triglycerides, cross-reacting plasma insulin, proinsulin and C-peptide but not specific insulin and split 32,33 proinsulin remained associated with carotid artery IMT. No associations remained after adjustment for BMI. Conclusions Fasting plasma proinsulin, C-peptide, and insulin by cross-reacting RIA was associated with common carotid artery IMT independent of several conventional risk factors for atherosclerosis. The multicollinearity between the insulin peptides and propeptides makes it difficult to clarify the exact role of each peptide. [source] Echo-Tracking Assessment of Carotid Artery Stiffness in Patients with Aortic Valve StenosisECHOCARDIOGRAPHY, Issue 7 2009Francesco Antonini-Canterin M.D. Background: There is little information about mechanical properties of large arteries in patients (pts) with aortic stenosis (AS). Methods: Nineteen patients with AS (aortic valve area: 0.88 ± 0.29 cm2) and 24 control subjects without AS but with a similar distribution of risk factors were recruited. , index, pressure-strain elastic modulus (Ep), arterial compliance (AC), augmentation index (AIx), and local pulse-wave velocity (PWV) were obtained at the level of right common carotid artery (CCA) by a real time echo-tracking system. Time to dominant peak of carotid diameter change waveform, corrected for heart rate (tDPc), and maximum rate of rise of carotid diameter (dD/dt) were measured. Systemic arterial compliance (SAC) was also calculated. Parameters of AS severity (mean gradient, valve area, stroke work loss [SWL]) were determined. Results: tDPc was higher in patients with AS than in controls (7.9 ± 0.6 vs. 6.6 ± 0.7, P < 0.0001) while dD/dt was lower (5.3 ± 3.6 mm/s vs. 7.8 ± 2.8 mm/s, P = 0.01). AIx was significantly higher in AS group (32.5 ± 13.6% vs. 20.6 ± 12.2%, P = 0.005) and had a linear correlation both with tDPc (r = 0.63, P < 0.0001) and with dD/dt (r =,0.38, P = 0.01). There was a significant correlation between carotid AC and SAC (r = 0.49, P = 0.03), but only carotid AC was related to SWL (r = 0.51, P = 0.02), while SAC was not (P = 0.26).Conclusions: AIx was the only parameter of arterial rigidity found to be higher in patients with AS than in controls. Carotid AC showed a significant correlation with SAC and it seemed to be more closely related to AS severity than to SAC. [source] Traumatic oesophageal rupture in a horse complicated by subsequent rupture of the common carotid arteryEQUINE VETERINARY EDUCATION, Issue 3 2003I. Risnes First page of article [source] Acute effects of caffeine and tobacco on arterial function and wave travelEUROPEAN JOURNAL OF CLINICAL INVESTIGATION, Issue 12 2006J. Swampillai Abstract Background, Caffeine and tobacco consumption are risk factors for heart failure, but their effects remain controversial. It has been hypothesized that they cause alterations in arterial stiffness and arterial wave travel which may increase ventricular loading. In this study the authors examined the influence of these widely used stimulants on wave intensity and arterial stiffness parameters using carotid wave intensity analysis. Materials and methods, A new Doppler-based ultrasound method was used to measure the acute effects of caffeine and tobacco on wave intensity in the right common carotid artery. The measurements enabled changes in arterial stiffness parameters to be recorded. Results, In 17 subjects compared with 10 controls, caffeine increased blood pressure, early systolic wave intensity and wave speed, but late-systolic wave intensity and mid-systolic reflections were unchanged. In 11 smokers studied before and after smoking one cigarette, blood pressure and arterial stiffness increased but wave intensity was unchanged. No changes were observed in the controls. Conclusions, Increased wave intensity during ejection after caffeine suggested sympathomimetic effects on the left ventricular function. Increased wave speed in the common carotid artery implied augmented central loading after caffeine, but the absence of measurable changes in local arterial stiffness in the carotid artery suggested more complex and regional effects. Cigarette smoking acutely increased local arterial stiffness in the common carotid artery. These changes can be detected using wave intensity analysis. [source] Thrombotic occlusion of the common carotid artery (CCA) in acute ischemic stroke treated with intravenous tissue plasminogen activator (TPA)EUROPEAN JOURNAL OF NEUROLOGY, Issue 2 2007V. K. Sharma Although common carotid artery (CCA) occlusions are rare, acute clinical presentations vary from mild to devastating strokes primarily due to tandem occlusions in the intracranial arteries. Three patients with acute CCA occlusions were treated with systemic tissue plasminogen activator (TPA). Blood pressures were kept at the upper limits allowed with TPA therapy with fluid balance and the ,head-down' position. Recanalization occurred in intracranial vessels only. Marked early neurological improvement occurred in two of three patients. CCA occlusions should not be considered contra-indication to systemic thrombolysis. [source] Microsphere embolism-induced cortical cholinergic deafferentation and impairments in attentional performanceEUROPEAN JOURNAL OF NEUROSCIENCE, Issue 11 2005Tara K. S. Craft Abstract Ischemic events have been hypothesized to play a critical role on the pathogenesis of dementia and the acceleration of cognitive impairments. This experiment was designed to determine the consequences of microvascular ischemia on the cortical cholinergic input system and associated attention capacities. Injections of microspheres (,50 µm diameter; ,5000 microspheres/100 µL) into the right common carotid artery of rats served as a model of microvascular ischemia and resulted in decreases in the density of cholinergic fibers in the ipsilateral medial prefrontal cortex and frontoparietal areas. Furthermore, dense astrogliosis, indicated by glial fibrillary acidic protein (GFAP) immunohistochemistry, was observed in the globus pallidus, including the areas of origin of cholinergic projections to the cortex. Fluoro-Jade B staining indicated that loss of neurons in the cortex was restricted to areas of microsphere-induced infarcts. Attentional performance was assessed using an operant sustained attention task; performance in this task was previously demonstrated to reflect the integrity and activity of the cortical cholinergic input system. Embolized animals' performance was characterized by a decrease in the animals' ability to detect signals. Their performance in non-signal trials remained unaffected. The residual density of cholinergic axons in prefrontal and frontoparietal areas correlated with the animals' performance. The present data support the hypothesis that microvascular ischemia results in loss of cortical cholinergic inputs and impairs associated attentional performance. Microsphere embolism represents a useful animal model for studying the role of interactions between microvascular disorder and impaired forebrain cholinergic neurotransmission in the manifestation of cognitive impairments. [source] Carotid intima-media thickness in late-onset major depressive disorderINTERNATIONAL JOURNAL OF GERIATRIC PSYCHIATRY, Issue 1 2006Cheng-Sheng Chen Abstract Background This study explored whether patients with late-onset major depressive disorder showed higher carotid artery intima-medium thickness (IMT) and investigated the relationship between the IMT and white matter hyperintensities on magnetic resonance imaging (MRI) among patients. Methods Fourteen elderly patients with late-onset major depressive disorder from a psychiatric outpatient clinic and 11 non-depressed controls received a comprehensive psychiatric assessment, ultrasound IMT measurements of the carotid arteries, and cerebral MRI. Results The carotid IMT was higher in the patient group vs the control group (1.26,±,0.30 vs 1.00,±,0.20,mm; t,=,2.40, p,<,0.03). The difference was more apparent in the common carotid artery (1.20,±,0.32 vs 0.97,±,0.13,mm; t,=,2.31, p,<,0.04). There was a high correlation (r,=,0.55, p,<,0.05) between the carotid IMT and white matter hyperintensities among patients with late-onset major depressive disorder. Conclusion Results of this study suggest that atherosclerosis represented by the carotid IMT contributes to the development of late-onset major depressive disorder. The findings support the vascular depression hypothesis. Copyright © 2005 John Wiley & Sons, Ltd. [source] Validation of the murine aortic arch as a model to study human vascular diseasesJOURNAL OF ANATOMY, Issue 5 2010Christophe Casteleyn Abstract Although the murine thoracic aorta and its main branches are widely studied to gain more insight into the pathogenesis of human vascular diseases, detailed anatomical data on the murine aorta are sparse. Moreover, comparative studies between mice and men focusing on the topography and geometry of the heart and aorta are lacking. As this hampers the validation of murine vascular models, the branching pattern of the murine thoracic aorta was examined in 30 vascular corrosion casts. On six casts the intrathoracic position of the heart was compared with that of six younger and six older men of whom contrast-enhanced computer tomography images of the thorax were three-dimensionally reconstructed. In addition, the geometry of the human thoracic aorta was compared with that of the mouse by reconstructing micro-computer tomography images of six murine casts. It was found that the right brachiocephalic trunk, left common carotid artery and left subclavian artery branched subsequently from the aortic arch in both mice and men. The geometry of the branches of the murine aortic arch was quite similar to that of men. In both species the initial segment of the aorta, comprising the ascending aorta, aortic arch and cranial/superior part of the descending aorta, was sigmoidally curved on a cranial/superior view. Although some analogy between the intrathoracic position of the murine and human heart was observed, the murine heart manifestly deviated more ventrally. The major conclusion of this study is that, in both mice and men, the ascending and descending aorta do not lie in a single vertical plane (non-planar aortic geometry). This contrasts clearly with most domestic mammals in which a planar aortic pattern is present. As the vascular branching pattern of the aortic arch is also similar in mice and men, the murine model seems valuable to study human vascular diseases. [source] Intima-media thickness of the common carotid artery in highway toll collectorsJOURNAL OF CLINICAL ULTRASOUND, Issue 9 2006Besir Erdogmus Abstract Purpose. To assess the effects of exposure to exhaust particles on intima-media thickness of the common carotid artery in highway toll collectors. Methods. Sixty-one highway toll collectors (HTCs) between 24 and 56 years of age (mean, 36.2 ± 7.3) and 48 controls between 24 and 64 years of age (mean, 42.6 ± 10.6) were evaluated with gray-scale sonography to measure intima-media thickness (IMT) of the common carotid artery (CCA). Subgroups were categorized according to duration of exhaust exposure and further divided according to tobacco use. Results. CCA IMT was higher (0.8 ± 0.2 mm) in HTCs than in the control group (0.6 ± 0.1 mm; p < 0.001) and remained higher when subgroups with similar smoking habits were compared. In HTCs, IMT was greater when the number of years working in tollbooths was greater (p = 0.023). IMT was lower in HTCs with an exposure duration of <10 years compared with a duration of 10,20 years (p = 0.017) or >20 years (p value not significant). Conclusion. Air pollution has a widely acknowledged negative effect on humans. This study confirms that exposure to exhaust particles might cause wall thickening of carotid arteries. © 2006 Wiley Periodicals, Inc. J Clin Ultrasound, 2006 [source] Circumferential strain in the wall of the common carotid artery: Comparing displacement-encoded and cine MRI in volunteersMAGNETIC RESONANCE IN MEDICINE, Issue 1 2008Alexander P. Lin The walls of conduit arteries undergo cyclic stretching from the periodic fluctuation of arterial pressure. Atherosclerotic lesions have been shown to localize to regions of excessive stretching of the arterial wall. We employed a displacement encoding with stimulated echoes (DENSE) sequence to image the motion of the common carotid artery wall and map the two-dimensional (2D) circumferential strain. The sequence utilizes a fully-balanced steady-state free-precession (SSFP) readout with 0.60 mm in-plane resolution. Preliminary results in volunteers at 1.5T (N = 4) and 3.0T (N = 17) are compared to measurements of the lumen circumference from cine images. The agreement between the two independent measurements at both field strengths (P , 0.001) supports the use of DENSE as a means to map the pulsatile strain in the carotid artery wall. Magn Reson Med 60:8,13, 2008. © 2008 Wiley-Liss, Inc. [source] Functional perfusion imaging using continuous arterial spin labeling with separate labeling and imaging coils at 3 TMAGNETIC RESONANCE IN MEDICINE, Issue 5 2003Toralf Mildner Abstract Functional perfusion imaging with a separate labeling coil located above the common carotid artery was demonstrated in human volunteers at 3 T. A helmet resonator and a spin-echo echo-planar imaging (EPI) sequence were used for imaging, and a circular surface coil of 6 cm i.d. was employed for labeling. The subjects performed a finger-tapping task. Signal differences between the condition of finger tapping and the resting state were between ,0.5% and ,1.1 % among the subjects. The imaging protocol included a long post-label delay (PLD) to reduce transit time effects. Labeling was applied for all repetitions of the functional run to reduce the sampling interval. Magn Reson Med 49:791,795, 2003. © 2003 Wiley-Liss, Inc. [source] Mucormycotic pseudoaneurysm of the common carotid artery with tracheal involvementMYCOSES, Issue 4 2008S. Hashemzadeh Summary Mucormycosis is an emerging and fatal fungal infection. A high index of suspicion and the knowledge of its potential manifestations are essential for early diagnosis. We describe a patient with acute lymphoblastic leukaemia (L2 subtype) who developed a neck mass following a course of induction chemotherapy. Doppler ultrasonography and angiography of the neck revealed a pseudoaneurysm of the right common carotid artery. The patient then developed haemoptysis. Surgical exploration revealed a necrotic right common carotid artery with anteromedial pseudoaneurysm and adjacent tracheal wall perforation. Local debridement and tracheal repair were performed. Nonseptate hypheal invasion (mucormycosis) was found on the microscopic examination of the excised arterial wall. A subsequent recurrence of pseudoaneurysm was treated with local surgical debridement and intravenous amphotericin B (Fungizone) administration. Although rare, clinicians should be aware of these possible presenting features of mucormycosis as early diagnosis and treatment may potentially improve the survival. [source] Continuous arterial spin labeling at the human common carotid artery: the influence of transit timesNMR IN BIOMEDICINE, Issue 1 2005Toralf Mildner Abstract In evaluating the sensitivity of arterial spin labeling (CASL) and for quantification of perfusion, knowledge of the transit time from the labeling plane to the imaging slice is crucial. The purpose of the current study was to obtain estimates of transit times relevant under the specific experimental conditions of CASL in human subjects using a separate local labeling coil at the neck. Specifically, the post-label delay (PLD), i.e. the time between the end of the labeling period and the image acquisition, was varied either with or without additional application of crusher gradients to suppress intravascular signal contributions. The overall sensitivity change for varying the PLD between 1000 and 1700,ms was low. A tissue transit time from the neck to an axial supraventricular section through Broca's knee was obtained by fitting the PLD dependence to a two-compartment model. Averaging over subjects yielded 1930,±,110,ms for the tissue transit time, and 73,±,5,ml,min,1 100,g,1 for the cerebral blood flow. Small areas that exhibited a very high signal change upon labeling were indicative of regional variation in cerebral blood flow related to vascular anatomy. Copyright © 2004 John Wiley & Sons, Ltd. [source] Carotid intima,media thickness in children and young adults with renal transplant: Internal carotid artery vs. common carotid arteryPEDIATRIC TRANSPLANTATION, Issue 8 2007Yelda Bilginer Abstract:, Cardiovascular diseases are the main causes of morbidity and mortality following renal transplantation. Atherosclerotic structural changes, which can be detected by high-resolution B-mode ultrasonography, begin before clinical findings. However, little is known about the extent of these abnormalities in children after renal transplantation. We aimed to determine early structural changes of large arteries in renal transplant recipients without cardiovascular disease and to evaluate the role of clinical and laboratory features on IMT of carotid arteries. IMT and hemoglobin, serum levels of creatinine, acute phase proteins, lipid profile, and homocysteine were examined in 24 asymptomatic renal transplant recipients (median age 16.5 yr; range 8,25), and 20 healthy controls (median age 16 yr; range 9,24). CCA and ICA were evaluated in patients and controls with a high-resolution B-mode ultrasonography in multiple projections to optimize detection of carotid IMT. Measurement of IMT of both CCA [0.36 mm (range 0.16,0.48) vs. 0.28 mm (range 0.21,0.35), p < 0.001] and ICA [0.27 mm (range 0.16,0.48) vs. 0.22 mm (range 0.1,0.26), p < 0.001] were significantly higher in renal recipients than in healthy controls. Among several parameters assessed, only significant correlations were found between duration of CRF, duration of dialysis prior to transplantation and ICA-IMT (p = 0.06 and p = 0.02, respectively) and between mean past serum calcium,phosphorus ion product and CCA-IMT (p = 0.002). In conclusion, our observations indicate that vascular changes begin early in the course of CRF and are directly related to time on CRF and dialysis. These changes can be detected by measuring CCA/ICA-IMT ultrasonographically. We suggest that early renal transplantation can potentially avoid long-term cardiovascular events in children with end stage kidney disease. [source] | |||||||||||||||||||||||||||||||