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Rivista di Angiologia

Official Journal of the International Union of Angiology, the International Union of Phlebology and the Central European Vascular Forum
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International Angiology 2003 March;22(1):83-7

lingua: Inglese

Interrelationship between peripheral arterial occlusive disease, carotid atherosclerosis and flow mediated dilation of the brachial artery

Poredos P., Golob M., Jensterle M.

Depart­ment of Vas­cu­lar Dis­ease, Uni­ver­sity Med­i­cal Cen­tre, Ljubl­ja­na, Slo­ve­nia


Aim. Ath­ero­scler­o­sis is con­sid­ered a system­ic dis­ease. There­fore, in ­patients with ath­e­ros­cle­rot­ic dis­ease ­effects on var­i­ous sec­tions of the arte­ri­al ­system are expect­ed. The aim of our study was to deter­mine wheth­er ­patients with evi­dent periph­er­al arte­ri­al occlu­sive dis­ease (PAOD) of the lower limbs have any sub­clin­i­cal func­tion­al or struc­tu­ral arte­ri­al wall chang­es in other sec­tions of the arte­ri­al ­system.
Meth­ods. The study includ­ed 54 ­patients with PAOD, Fon­taine stage II and a claud­i­ca­tion dis­tance from 50 to 500 ­m (aver­age 250±170 m). Their mean age was 64. None of them had any symp­toms or signs of cor­o­nary or cereb­ro­vas­cu­lar ath­ero­scler­o­sis (CVD). The con­trol group con­sist­ed of 50 ­healthy vol­un­teers with a mean age of 64 years with­out any risk fac­tors of ath­ero­scler­o­sis. In all sub­jects the carot­id inti­ma-media thick­ness (IMT), was meas­ured, the pres­ence of ath­e­ros­cle­rot­ic ­plaques in the carot­id ­artery (CA) was reg­is­tered and the endo­the­li­um-depen­dent dila­tion capa­bil­ity of the bra­chi­al ­artery (BA) dur­ing reac­tive hyper­emia was meas­ured using the B-mode ultra­sound tech­nique.
­Results. The aver­age IMT was sig­nif­i­cant­ly great­er in PAOD ­patients than in con­trols (0.8±0.2 mm vs 0.6±0.1 mm, p<0.001). In ­patients ath­e­ros­cle­rot­ic ­plaques in the CA were also more numer­ous than in con­trols (38 vs 4, p<0.001). The IMT of ­patients was relat­ed to body mass index (BMI), ankle-bra­chi­al pres­sure index (ABI), LDL cho­les­te­rol and to the num­ber of ath­e­ros­cle­rot­ic ­plaques. In PAOD ­patients flow-medi­at­ed dila­tion of the BA was sig­nif­i­cant­ly lower than in con­trols (7.2±4.9% vs 12.3±2.1%, p<0.001). The dila­tion capa­bil­ity of the BA was lin­e­ar­ly relat­ed to the BMI, ABI and IMT.
Con­clu­sion. The ­results of our study show that PAOD ­patients with­out clin­i­cal evi­dence of CVD have mor­pho­log­i­cal chang­es of the CA, ­increased IMT and numer­ous ath­e­ros­cle­rot­ic ­plaques. Fur­ther­more, in PAOD ­patients flow-medi­at­ed endo­the­li­um-depen­dent dila­tion of the periph­er­al arter­ies is ­decreased. These ­results sup­port the hypoth­e­sis that ath­ero­scler­o­sis is a gen­er­al­ized dis­ease, lead­ing to func­tion­al and struc­tu­ral chang­es in sev­er­al seg­ments of the arte­ri­al ­system.

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