|
|
Carotid Artery Stenosis
Svoboda, Norbert ; Beneš, Vladimír (advisor) ; Peisker, Tomáš (referee) ; Herzig, Roman (referee)
The basis of the doctoral thesis consists of three studies focused on the diagnosis of carotid stenosis. The first study examines the histological structure of carotid plaques and their relationship to clinical manifestations. The study included 269 patients with 280 analyzed plaques. Multiple logistic regression demonstrated a significant association between symptomatic stenosis and foam cells (OR=1.9, p=0.03) as well as plaque thrombosis (OR=3.5, p=0.02). A significant correlation was also found between symptomatic plaque and unstable plaque according to the comprehensive AHA plaque classification (OR=1.8, p=0.03).The second study addresses the accuracy of carotid stenosis diagnosis using digital subtraction angiography (DSA). Carotid stenosis was measured on DSA and histologically processed plaques obtained during carotid endarterectomy in 644 patients. The study did not establish a correlation between the findings on the histological plaque and DSA (correlation coefficient of 0.22 for ECST and 0.20 for NASCET). The last study focuses on the analysis of the biomarker of oxidative stress (malondialdehyde, MDA) as a predictor of unstable carotid plaques. The study involved 35 patients. Patients with asymptomatic carotid stenosis and those who experienced amaurosis fugax had significantly lower...
|
|
| |
|
| |
|
|
Age dependent decrease of cerebro-vascular reactivity and its impact on brain parenchyme integrity
Peisker, Tomáš ; Kalvach, Pavel (advisor) ; Zvěřina, Eduard (referee) ; Hort, Jakub (referee)
Summary: Sufficient vasodilatory and vasoconstrictive reactivity of cerebral arterioles is an important prerequisite for adequate capillary perfusion. To appreciate its capacity during aging and to elucidate its impact on parenchymal integrity we undertook a correlation using ultrasonography and brain MRI. Sixty healthy persons with no stenoses in carotid and vertebral arteries were examined by transcranial doppler ultrasonography (TCD) to assess middle cerebral artery mean flow velocities (MFV) et rest, after 30 sec apnea and after 90 sec hyperventilation. Young persons, N=20, mean age 24,8 (20- 32) were compared with middle aged, N=20, 54,8 (40-63) and elderly, N=20, 76,2 (69-84). A cohort of 40 elderly persons, mean age 68,4 (57-85) were evaluated also by MRI using FLAIR and T2-weighted sequences. Their extent of leukoaraiosis measured by the Fazekas scale was correlated with their vasoregulatory capacity. Results: The steady state mean flow velocity (MFV) in young persons, 71 cm/sec, decreases to 48,1 and to 44,9 cm/sec in the middle and the old aged. The postapnoic vasodilatation in young persons accelerates the MCA blood velocity by 41,7%, while in middle and old age only by 37,9 and 32,7% respectively. The MCA deceleration post hyperventilation by 49,8% in young people decreases to 37,8% and to 29,7%...
|
|
| |
|
|
Age dependent decrease of cerebro-vascular reactivity and its impact on brain parenchyme integrity
Peisker, Tomáš ; Kalvach, Pavel (advisor) ; Zvěřina, Eduard (referee) ; Hort, Jakub (referee)
Summary: Sufficient vasodilatory and vasoconstrictive reactivity of cerebral arterioles is an important prerequisite for adequate capillary perfusion. To appreciate its capacity during aging and to elucidate its impact on parenchymal integrity we undertook a correlation using ultrasonography and brain MRI. Sixty healthy persons with no stenoses in carotid and vertebral arteries were examined by transcranial doppler ultrasonography (TCD) to assess middle cerebral artery mean flow velocities (MFV) et rest, after 30 sec apnea and after 90 sec hyperventilation. Young persons, N=20, mean age 24,8 (20- 32) were compared with middle aged, N=20, 54,8 (40-63) and elderly, N=20, 76,2 (69-84). A cohort of 40 elderly persons, mean age 68,4 (57-85) were evaluated also by MRI using FLAIR and T2-weighted sequences. Their extent of leukoaraiosis measured by the Fazekas scale was correlated with their vasoregulatory capacity. Results: The steady state mean flow velocity (MFV) in young persons, 71 cm/sec, decreases to 48,1 and to 44,9 cm/sec in the middle and the old aged. The postapnoic vasodilatation in young persons accelerates the MCA blood velocity by 41,7%, while in middle and old age only by 37,9 and 32,7% respectively. The MCA deceleration post hyperventilation by 49,8% in young people decreases to 37,8% and to 29,7%...
|
|
| |
guest ::
