Carotid artery atherosclerotic profile as a predictor of the aorta atherosclerotic profile in patients with cerebrovascular events

Background: It is well known that the presence of atheroma of the thoracic aorta is a risk factor for cerebrovascular events. We sought to evaluate whether the presence and the morphology of atherosclerotic plaque in the carotid artery detected by duplex ultrasonography is associated with disease in the proximal aorta visualized by transesophageal echocardiogram in patients with a cerebrovascular event. Methods: We carried out a cross-sectional prospective study including 147 consecutive patients with prior stroke or transient ischemic attack (TIA). Neurological evaluations were performed by an expert neurologist using clinical and tomographic diagnostic criteria including the definition of etiology and whether the patient suffered from stroke or TIA. Transthoracic and transesophageal echocardiograms and carotid artery duplex ultrasonography were performed by the same examiner. Patients with and without plaque in the carotid artery were compared using Student's t test or the χ2 test. Regression analysis was used to determine whether the presence of plaque in the carotid artery was predictive of the presence of plaque in the proximal aorta and to analyze the relationship between the echogenicity of carotid and aortic plaques. The significance level was set at p < 0.05. Results: All 147 patients (95 men) were included in the analysis. Patients' ages ranged from 23 to 85 years (65 ± 12.4 years). Most of the patients (58.5%) were Caucasian, while 41.5% were African-Brazilian. Arterial hypertension, diabetes and tobacco use were more frequent among patients with atherosclerotic plaque in the aorta. A normal carotid intima-media thickness halved the risk of atherosclerotic plaque in the aorta [odds ratio (OR) 0.46, 95% confidence interval (CI) 0.23-0.91; p = 0.026]. The presence of carotid plaque increased the risk of aortic plaque by 70-fold (OR 73.2, 95% CI 25.6-2,018.6; p < 0.001) in univariate analysis. The absence of atherosclerotic plaque in the carotid artery reduced the risk of plaque in the aorta to almost 0 (OR 0.014, 95% CI 0.004-0.041; p < 0.001). Considering the 86 patients with both aortic and carotid plaques, the presence of hypoechoic plaque in the carotid artery was a predictor of hypoechoic plaque in the aorta (OR 10.1, 95% CI 3.3-31.2; p < 0.001). Conclusions: The carotid artery atherosclerotic profile defined by ultrasonography is a strong predictor of the atherosclerotic profile of the proximal aorta. This should be taken into consideration before referring patients with acute cerebrovascular events for transesophageal echocardiogram. © 2013 S. Karger AG, Basel.

Ultrasound evaluation of common carotid artery blood flow in the Labrador retriever

Background: Doppler ultrasound (DUS) examination provides quantitative and qualitative information concerning the blood flow in veins and arteries, enabling their morphological evaluation and the collection of hemodynamic data. Dogs and cats as well as humans may display neurological signs of brain hypoperfusion secondary to common carotid alterations. Hence, DUS examination might aid in the differential diagnosis of neurological disorders of ischemic origin, among other causes. The objective of this study was to register normal values for systolic peak velocity, minimum diastolic velocity, diameter and resistance index of both common carotid arteries of 12 healthy Labrador retriever dogs between 2 and 5 years of age. By gathering these values, we might be able to improve the sensitivity of hemodynamic studies in clinically important brain disorders. Results: There were no statistical differences between the values for the right and left vessels: the systolic peak velocity was 75.8 ± 16 cm/s, minimum diastolic velocity was 12.2 ± 4 cm/s, common carotid diameter was 0.545 ± 0.063 cm, and resistance index was 0.83 ± 0.07. Conclusions: The results of this study might be used to establish normal parameters for Labrador retriever dogs and thus help in the diagnosis of neurological disorders associated with alterations of the carotid arteries. Similar studies must be performed to evaluate the same parameters in other dog breeds of different sizes and skull conformations. © 2013 Svicero et al.; licensee BioMed Central Ltd.

Utilidade da ultra-sonografia no manejo do derrame pleural parapneumônico em crianças

Pós-graduação em Bases Gerais da Cirurgia - FMB

Otimização de imagem de torax para radiografia computadorizada

Pós-graduação em Biologia Geral e Aplicada - IBB

Estudo radiográfico da espessura do esmalte nas faces proximais de dentes anteriores e posteriores

Coordenação de Aperfeiçoamento de Pessoal de Nível Superior (CAPES)

Alterações cefalométricas do perfil facial decorrentes do crescimento natural e induzidas pelo aparelho de Herbst no tratamento da classe II divisão 1, em fase pré-puberal

Coordenação de Aperfeiçoamento de Pessoal de Nível Superior (CAPES)

Avaliação do seio maxilar após fratura do complexo zigomático-maxilar tratado com fixação interna rígida em dois pontos: estudo radiográfico em humanos

Pós-graduação em Odontologia - FOA

Análise do sistema respiratório dos suínos por radiografia, broncoscopia e toracoscopia

Fundação de Amparo à Pesquisa do Estado de São Paulo (FAPESP)

Aspectos ultrassonográficos, biometria e dopplerfluxometria ocular de primatas-Alouatta fusca (BUGIO RUIVO-Geoffroy Saint-Hilaire, 1812)

Pós-graduação em Medicina Veterinária - FMVZ

Fraturas de rádio e ulna em cães no período de janeiro de 2001 a dezembro de 2011

Pós-graduação em Cirurgia Veterinária - FCAV

Pelvimetria radiográfica em diferentes raças de fêmeas caninas adultas (Canis familiaris-LINNAEUS, 1758)

Conselho Nacional de Desenvolvimento Científico e Tecnológico (CNPq)

Aspectos radiográficos e tomográficos de felinos (Felis catus - Linnaeus, 1775) adultos acometidos por rinite e sinusite

Conselho Nacional de Desenvolvimento Científico e Tecnológico (CNPq)

Avaliação radiográfica da articulação coxofemoral em cães submetidos a exercícios físicos

Conselho Nacional de Desenvolvimento Científico e Tecnológico (CNPq)

Avaliação estrutural da próstata de cães: comparação entre punção aspirativa com agulha fina guiada por ultra-som e biópsia por videolaparoscopia

Coordenação de Aperfeiçoamento de Pessoal de Nível Superior (CAPES)

Estudo radiográfico retrospectivo de lesões ósseas mandibulares em cães

Pós-graduação em Cirurgia Veterinária - FCAV