Document Detail


Severity of coronary artery disease but not degree of coronary stenosis is correlated to cerebrovascular reactivity.
MedLine Citation:
PMID:  19609081     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
BACKGROUND: A decade difference in peak incidences of coronary and cerebral ischemia assumes a protection of the brain vasculature. Therefore, we hypothesize that early indicators of cerebrovascular disease such as parameters of the neurovascular coupling show a higher correlation to coronary artery disease than morphologic parameters. METHODS: Stenotic degree (%) of coronary arteries (RCA, LCA, LAD, RCX) was determined together with the Gensini score by angiography in 96 patients (80 men; 62 +/- 10 years), which were grouped according to disease severity (sclerosis, 1-vessel disease (VD), 2-VD, 3-VD). Presence of internal carotid artery stenosis and left ventricular ejection fraction (LVEF) were established with duplex sonography. Resting and visually evoked hemodynamic responses were measured with transcranial Doppler ultrasound in both posterior cerebral arteries and expressed in terms of control system parameters. These were gain, natural frequency, attenuation, and rate time. Group differences and correlations between stenosis and parameters of vasoreactivity were tested. RESULTS: Groups differed in stenotic degree of coronary arteries, Gensini score, LVEF, carotid artery stenosis, resting flow velocity, and evoked responses (gain, p < 0.005; attenuation, p < 0.05). Stenosis of each coronary artery and LVEF were correlated to carotid artery stenosis but no association was found to cerebrovascular parameters. Only severity of coronary artery disease and the Gensini score were associated with disturbed cerebrovascular reactivity. Carotid artery stenosis was associated with decreased cerebrovascular parameters (attenuation, p < 0.05; rate time, p < 0.01). CONCLUSIONS: Although atherosclerosis is a systemic disease our data support concepts of a heterogeneous distribution of the disease indicating protection of brain vessels.
Authors:
B Rosengarten; M Grebe; A Muller; R K Voss; M Kaps
Publication Detail:
Type:  Journal Article     Date:  2009-07-16
Journal Detail:
Title:  Cerebrovascular diseases (Basel, Switzerland)     Volume:  28     ISSN:  1421-9786     ISO Abbreviation:  Cerebrovasc. Dis.     Publication Date:  2009  
Date Detail:
Created Date:  2009-08-12     Completed Date:  2009-10-23     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  9100851     Medline TA:  Cerebrovasc Dis     Country:  Switzerland    
Other Details:
Languages:  eng     Pagination:  290-7     Citation Subset:  IM    
Copyright Information:
Copyright (c) 2009 S. Karger AG, Basel.
Affiliation:
Center of Neurology and Neurosurgery, Department of Neurology, Justus-Liebig University of Giessen, Giessen, Germany. Bernhard.Rosengarten@neuro.med.uni-giessen.de
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MeSH Terms
Descriptor/Qualifier:
Adult
Aged
Aged, 80 and over
Carotid Arteries / ultrasonography
Cerebrovascular Circulation / physiology*
Coronary Angiography
Coronary Artery Disease / complications*,  physiopathology,  ultrasonography
Coronary Stenosis / complications*,  physiopathology,  ultrasonography
Female
Humans
Laser-Doppler Flowmetry
Male
Middle Aged
Photic Stimulation
Posterior Cerebral Artery / physiology
Ultrasonography, Doppler, Duplex
Ultrasonography, Doppler, Transcranial
Ventricular Function, Left / physiology

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