doiSerbia

Carotid artery wall stiffness is increased in patients with small vessel disease: A case-control study

Salihović-Hajdarević Denisa (University Clinical Center Tuzla, Department of Neurology, Tuzla, Bosnia and Herzegovina)
Pavlović Aleksandra M. (School of Medicine, Belgrade + Clinical Center of Serbia, Neurology Clinic, Belgrade)
Smajlović Dževdet (University Clinical Center Tuzla, Department of Neurology, Tuzla, Bosnia and Herzegovina)
Podgorac Ana (School of Medicine, Belgrade + Clinical Center of Serbia, Neurology Clinic, Belgrade)
Jovanović Zagorka (School of Medicine, Belgrade + Clinical Center of Serbia, Neurology Clinic, Belgrade)
Švabić-Međedović Tamara (School of Medicine, Belgrade + Clinical Center of Serbia, Neurology Clinic, Belgrade)
Čovičković-Šternić Nadežda (School of Medicine, Belgrade + Clinical Center of Serbia, Neurology Clinic, Belgrade)

Introduction. Cerebral ischemic small-vessel disease (SVD), causing lacunar infarcts and white matter hyperintensities on brain magnetic resonance imaging (MRI), is a progressive disease associated with an increased risk of stroke, dementia and death. Increased arterial stiffness has been associated with ischemic stroke and cerebral SVD independently of common vascular risk factors. Objective. The aim of the study was to analyze arterial stiffness in our patients with symptomatic SVD. Methods. In a cross-sectional study design we included 30 patients with clinical and MRI evidence of cerebral SVD and 30 age-, gender- and risk factor-matched control subjects with no neurological diseases. Patients were evaluated at the Ultrasound Laboratory at the Neurology Clinic, Clinical Center of Serbia in Belgrade, during a three-month period (from September 1st to December 1st 2012). Baseline demographic and vascular risk factors were recorded. All patients underwent standard carotid ultrasound scans with measuring of intima-media thickness (IMT) and analysis of atheromatous plaques. Internal carotid artery stiffness was evaluated with the use of e-tracking option as beta stiffness index (BSI) value. Results. There were no differences between study groups in regard to degree of carotid stenosis and type of carotid plaques (p>0.05). Patients in SVD group had significantly higher mean IMT (p=0.0093) and mean BSI (p<0.0001) than subjects in the control group. No significant correlation was detected between IMT and BSI in SVD group (r=0.168; p=0.376). Brain lesions severity correlated with BSI (r=0.733; p<0.0001). Conclusion. Arterial stiffness is increased in symptomatic patients with SVD, independently of vascular risk factors and IMT.

Keywords: carotid artery, intima-media thickness, arterial stiffness, beta stiffness index

Projekat Ministarstva nauke Republike Srbije, br. 175022