title: Correlation of carotid artery disease severity and vasomotor response of cerebral blood vessels.
abstract: We assessed reactivity of cerebral vessels on hypercapnia in patients with carotid occlusive disease. The effects of vascular risk factors on carotid atherosclerosis and vasomotor reactivity (VMR) of cerebral arterioles were also examined. Patients (n = 50) with carotid stenosis (≥30% in 1 or both sides) were included; 30 patients acted as controls. Hypertension, hyperlipidemia, diabetes, cardiac diseases, inflammation, and smoking were recorded. Vasomotor reactivity was assessed with the apnea test by transcranial Doppler ultrasonography and estimated by flow velocity changes in the middle cerebral artery before and after hypercapnia induction. Vasomotor reactivity was defined by the breath holding index, and values under 0.69 were considered critical for VMR impairment. Vasomotor reactivity reduction was significant (P = .004) in patients with severe carotid stenosis (>70%) and with symptomatic carotid disease (P < .05). The risk factors did not significantly influence VMR reduction. Severe carotid stenosis impairs VMR and may increase the risk of stroke, especially in symptomatic patients.
authors.affiliation: Special Hospital for Cerebrovascular Diseases, "Sveti Sava," Belgrade, Serbia ivanakrdzic@gmail.com.
authors.forename: Ivana
authors.initials: I
authors.lastname: Krdžić
authors.affiliation: Institute for Neurology, Clinical Hospital Center, Belgrade University of Medicine, Belgrade, Serbia.
authors.forename: Nadežda
authors.initials: N
authors.lastname: Čovičković-Šternić
authors.affiliation: Second Propedeutic Department of Internal Medicine, Hippocration Hospital, Medical School, Aristotle University of Thessaloniki, Thessaloniki, Greece.
authors.forename: Niki
authors.initials: N
authors.lastname: Katsiki
authors.affiliation: Laboratory of radiobiology and molecular genetics, Institut of nuclear science "Vinca", University of Belgrade, Belgrade, Serbia.
authors.forename: Esma R
authors.initials: ER
authors.lastname: Isenović
authors.affiliation: Institute for Cardiovascular Diseases "Dedinje," Belgrade Faculty of Medicine, University of Belgrade, Belgrade, Serbia.
authors.forename: Đorđe
authors.initials: Đ
authors.lastname: Radak
mesh_terms: D000368:Aged; D001160:Arterioles / Q000000981:diagnostic imaging / Q000503:physiopathology; D001783:Blood Flow Velocity; D001921:Brain / Q000098:blood supply*; D016893:Carotid Stenosis / Q000150:complications / Q000175:diagnosis / Q000503:physiopathology*; D016022:Case-Control Studies; D002560:Cerebrovascular Circulation; D005260:Female; D006706:Homeostasis; D006801:Humans; D006935:Hypercapnia / Q000503:physiopathology; D008297:Male; D008875:Middle Aged; D020768:Middle Cerebral Artery / Q000000981:diagnostic imaging / Q000503:physiopathology*; D012039:Regional Blood Flow; D012307:Risk Factors; D012720:Severity of Illness Index; D017585:Ultrasonography, Doppler, Transcranial; D014661:Vasoconstriction; D014664:Vasodilation
keywords: carotid artery stenosis; cerebral vessels; hypercapnia; vascular risk factors; vasomotor reactivity