頸動脈狭窄における収縮期血圧と脳血流の検討 (in English)

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  • Peak systolic velocity of carotid artery disease could reflect the pathophysiology of atherothrombotic brain infarction

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Introduction: Atherosclerotic carotid artery disease (CAD) is a major cause of ischemic stroke. Duplex ultrasonography (DUS) is one of the most valuable examinations which can provide not only morphologic data but also velocity. The purpose of this study is to investigate relationship among hemodynamic impairment (HDI), peak systolic velocity (PSV) in patients with CAD. <br> Methods: From April 2009 and May 2019, 104 patients suffering from atherothrombotic brain infarction (ATBI) due to CAD were collected in this study. Magnetic resonance imaging (MRI), DUS and quantitative single-photon emission computed tomography (QSPECT) were conducted. All patients were divided into 2 groups according to cerebrovascular reserve capacity (CVRC) of ≥10% or <10% and designated non-HDI group or HDI group, respectively. <br> Results: The number of non-HDI group and HDI group were 67 and 37. NASCET stenosis ratio and peak systolic velocity (PSV) were significantly higher in HDI group (71.3 ± 10.5% vs. 77.2 ± 8.3%, ρ < 0.01; 299 ± 153cm/s vs. 431 ± 131cm/s, ρ < 0.0001; respectively). A multi-logistic regression analysis revealed that high PSV (odds ratio, 65.94; 95% CI, 4.78–910.10; ρ < 0.001) was independently associated with HDI. A receiver operating characteristic curve of PSV to distinguish non-HDI and HDI showed area under the curve was 0.768. Cutoff value was PSV = 381cm/s. This study demonstrated increasing PSV was independently associated with HDI in patients with ATBI.

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