engleski

CORRELATION BREATH HOLDING INDEX AND PLAQUE MORPHOLOGY IN PATIENTS WITH SYMPTOMATIC OCCLUSIVE DISEASE

Background: The aim of the study was to evaluate plaque morphology in high grade internal carotid artery stenosis and its influence on cerebral hemodynamics. We used breath holding index (BHI) as a quantitative parameter of cerebral vasoreactivity and functional state of cerebral haemodynamics. Methods: We evaluated data from 150 patients with high grade carotid stenosis (definition according to standardized criteria of Cerebrovascular laboratory-Refferal Center for Neurovascular Disorders Ministry of Health Republic of Croatia). All patients underwent CDFI, TCD and CT/MR imaging tests, complete laboratory workup, ECG, chest X-ray and spinal tap in selected cases. CDFI and TCD findings were done in standardized manner. Breath holding index was calculated as percentage increase in MBFV occurring during breath holding divided by the time (seconds) for which the subject hold his/her breath. All patients had verified recent ischemia of brain parenchyma on CT/MR scan. Results: There were 55 patients (37%) with high grade stenosis of right internal carotid artery -30 men (20%) and 25 women (17%). There were 95 patients (63%) – 50 men (33%) and 45 women (30%) who had high grade stenosis of left internal carotid artery. There were 59 patients (39%) with hyperechoic plaques-32 men (21%) and 27 women (18%) ; 19 patients (13%) with isoechoic plaques- 9 men (6%) and 10 women (7%) and 72 patients (48%) with hypoechoic plaques- 39 men (26%) and 33 women (22%). There were no statistically significant differences in BHI depending on age and sex in each group of patients divided by plaque echogenicity-all patients . There was statistically significant differences in mean BHI values between each group of patients who activated same intracranial collateral pathways ; group of patients with hyperechoic plaques has shown high variation coefficient=20, probably because in this cases is very hard to define exact grade of stenosis because of plaque morphology and hemodynamic characteristics-soft core inables instability of plaque. Conclusion: In evaluation of patients with high grade carotid stenosis is very impotant to determine the ehogenicity of plaque because it has impact on cerebral hemodynamics and vasoreactivity (BHI) as it's quantitative measure.

breath holding Index; transcranial doppler; plaque morphology; carotid stenosis

nije evidentirano