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Objective: To investigate vascular and perivascular abnormalities in the carotid arteries using ultrasound, as well as to evaluate their association with mortality and clinical variables in hospitalized patients with coronavirus disease 2019 (COVID-19). Materials and Methods: This was a prospective study in which 53 hospitalized patients with severe COVID-19 were evaluated and underwent carotid ultrasound. We documented the carotid ultrasound findings in these patients. Clinical, demographic, laboratory, and imaging features were analyzed and compared by statistical analysis to detect correlations between them. Results: Carotid ultrasound demonstrated luminal surface irregularity in 29 patients (55%), carotid plaques in 30 (57%), perivascular infiltration in four (8%), and increased intima–media thickness (IMT) in 31 (58%). Of the 31 patients with increased IMT, 19 (61%) died, and the association between increased IMT and COVID-19–related mortality was significant (p = 0.03). Logistic regression showed that the risk of death was 85% in patients who had increased IMT in combination with acute kidney injury at admission or a history of chronic kidney disease (p < 0.05). Conclusion: In hospitalized patients with severe COVID-19, carotid ultrasound can show increased IMT, luminal surface irregularity, carotid plaques, and perivascular infiltrates. The combination of increased IMT and kidney damage appears to increase the risk of death in such patients. Resumo Objetivo: Investigar anormalidades vasculares e perivasculares nas artérias carótidas por meio de ultrassonografia e avaliar sua associação com mortalidade e variáveis clínicas em pacientes hospitalizados com COVID-19. Materiais e Métodos: Neste estudo prospectivo, 53 pacientes hospitalizados com COVID-19 grave foram avaliados e submetidos a ultrassonografia de carótida. Descrevemos os achados ultrassonográficos de carótida nesses pacientes. As correlações de características clínicas, demográficas, laboratoriais e de imagem foram analisadas e comparadas por meio de análise estatística. Resultados: A ultrassonografia carotídea demonstrou irregularidade da superfície luminal em 29 pacientes (55%), placas carotídeas em 30 pacientes (57%), infiltração perivascular em quatro pacientes (7,5%) e aumento da espessura médio-intimal (EMI) em 31 pacientes (58%). Dos pacientes com EMI aumentada, 19 (61%) morreram, com associação observada entre EMI aumentada e mortalidade por COVID-19 (p = 0,03). Um modelo de regressão logística mostrou que a probabilidade de óbito foi de 85% em pacientes com EMI aumentada e história de nefropatia crônica ou lesão renal aguda na internação (p < 0,05). Conclusão: Aumento da EMI, irregularidade da superfície luminal, placas carotídeas e infiltrados perivasculares foram encontrados na ultrassonografia carotídea em pacientes hospitalizados com COVID-19 grave. O aumento da EMI associado a danos nos rins pode aumentar o risco de morte.

SUMMARY Homozygous familial hypercholesterolemia is a rarely agentic disorder of the lipoprotein metabolism intimately related to premature atherosclerotic cardiovascular disease that can lead to high disability and mortality. Homozygous familial hypercholesterolemia typically affects not only the aortic root, compromising the coronary ostia, but also affects other territories such as the carotid, descending aorta, and renal arteries. Multi-contrast high-resolution magnetic resonance imaging (MRI) provides a validated and useful method to characterize carotid artery atherosclerotic plaques quantitatively. However, very few studies have been done on assessing plaque composition in patients with Homozygous familial hypercholesterolemia using high-resolution MRI. This report is to evaluate the value of MRI in accessing carotid artery disease in patients with Homozygous familial hypercholesterolemia. We describe a 28-year-old patient from Beijing, China, who presented to the Neurology Clinic with intermittent blurred vision of the right eye, headache, nausea, and vomiting for eight years without obvious causes. Familial hypercholesterolemia was suspected based on medical history and laboratory examination. Carotid Doppler ultrasound showed bilateral common carotid artery, internal carotid artery, and external carotid artery wall thickening with hyperechoic signals. Subsequently, high-resolution multi-contrast MRI of the carotid showed calcification with hypo-intense areas located at the middle layer of the plaque, with moderate stenosis. The plaque located at the right bifurcation of the common carotid artery extended to the internal carotid artery, causing lumen stenosis close to occlusion. The patient was treated with right carotid artery endarterectomy. At a 6-month follow-up, there had been no recurrence of the patient’s symptoms. RESUMO A hipercolesterolemia familiar homozigótica, uma doença patogênica rara do metabolismo da lipoproteína intimamente relacionada com a doença cardiovascular aterosclerótica prematura, pode conduzir a uma elevada deficiência e mortalidade. A hipercolesterolemia familiar homozigótica afeta tipicamente não só a raiz aórtica, comprometendo os óstios coronários, mas também outros territórios, como a carótida, a aorta descendente e as artérias renais. Imagens de ressonância magnética multicontraste de alta resolução (RM) fornecem um método validado e útil para caracterizar quantitativamente as placas de aterosclerose da artéria carótida. No entanto, muito poucos estudos foram feitos sobre a avaliação da composição da placa em doentes com hipercolesterolemia familiar homozigótica utilizando ressonância magnética de alta resolução. Este trabalho deve avaliar o valor da ressonância magnética no acesso à doença da artéria carótida em doentes com hipercolesterolemia familiar homozigótica. Descrevemos um paciente de 28 anos de Pequim, China, que se apresentou à clínica neurológica com visão turva intermitente do olho direito, dor de cabeça, náuseas e vômitos por oito anos sem causas aparentes. Suspeitava-se de hipercolesterolemia familiar com base no histórico médico e no exame laboratorial. O ultrassom Doppler carotídeo mostrou uma artéria carótida bilateral comum, artéria carótida interna e parede da carótida externa espessando-se com sinais hiperecoicos. Posteriormente, a ressonância multicontraste de alta resolução da carótida mostrou calcificação com áreas hipointensas localizadas na camada média da placa, com estenose moderada. A placa localizada na bifurcação direita da artéria carótida comum estendia-se até a artéria carótida interna, causando estenose do lúmen próxima à oclusão. O paciente foi tratado com endarterectomia da artéria carótida direita. Em seis meses de acompanhamento, não houve recorrência dos sintomas do paciente.

Introduction: With regular use of orthopantomography in the dental clinic, it helps patients and the health system to prevent cerebrovascular accidents that cause a significant amount of deaths in the population. Objetives: Visualization, prevalence, relationships and risks factors in relation to carotid calcifications in orthopantomography. Materials and methods: The study it has been made by analyzing 61 studies between the years 2002 and 2019, through the use of digital platforms such as PubMed, Sciielo, Medline and ScienceDirect. Discussion: After collecting the information by analyzing the referenced studies, we compared all the studies to arrive at a figure with the least possible bias of calcified atheroma plaques in panoramic radiographs of dental clinics. Conclusion: Panoramic radiographs are a good method for detect calcified atheroma plaques in the carotid artery, Introducción: Mediante el uso habitual de las ortopantomografías en las clínicas dentales se puede ayudar al sistema de salud y a los pacientes enfermos en la prevención de accidentes cerebrovasculares causantes de una parte importante de los decesos en la población. Objetivos: Visualización, prevalencia, relaciones y factores de riesgo en relación con las calcificaciones carotideas en ortopantomografías. Material y método: El trabajo se ha realizó mediante el análisis de 61 estudios comprendidos entre los años 2002 y 2019, mediante el uso de plataformas digitales como PubMed, Sciielo, MedLine y ScienceDirect. Discusión: Tras la recopilación de la información mediante el análisis de los estudios referenciados comparamos todos los estudios para llegar a una cifra con el menor sesgo posible de placas de ateroma calcificadas en las radiografías panorámicas de las clínicas dentales. Conclusiones: Las radiografías panorámicas son un buen método para detectar placas de ateroma calcificadas en la arteria carótida., Universidad Europea de Madrid, Grado en Odontología, Presencial

[spa] La infección por VIH se ha convertido en una enfermedad crónica y en este contexto, las comorbilidades asociadas cobran un papel destacado. Entre ellas las enfermedades cardiovasculares, tienen un papel predominante. Diferentes aspectos propios de la infección por VIH y del tratamiento antirretroviral intervienen en la fisiopatología de la enfermedad cardiovascular en este contexo. Marcadores subrogados de ateromatosis subclínica, como la ecografía carotídea o medidas de rigidez arterial, son de utilidad para estudiar el impacto de diferentes factores en la salud cardiovascular. El objetivo principal de esta tesis es estudiar los principales factores que influyen en la salud cardiovascular de personas con infección por VIH y evaluar el potencial impacto de diferentes fármacos antirretrovirales, a nivel metabólico y de marcadores subrogados de ateromatosis subclínica. Para ello se diseñaron varios estudios. El primer estudio compara una pauta de tratamiento antirretroviral de inicio con darunavir/ritonavir frente a atazanavir/ritonavir, ambos con tenofovir/emtricitabina. No se encontraron diferencias significativas en los cambios en colesterol total, LDL ni HDL. Se observó un mayor aumento de triglicéridos, asociado a resistencia a la insulina con atazanavir, aunque no está clara la implicación clínica que estas diferencias pueden tener. En el segundo estudio, observamos que la grasa corporal aumentó más en los pacientes tratados con atazanavir, pero se encontró un mayor aumento de la grasa de extremidades y del tejido adiposo subcutáneo, no del tejido adiposo visceral, lo que podría implicar un balance global positivo a nivel metabólico y cardiovascular. El tercer estudio, evalúa la progresión de ateromatosis subclínica y mostró que el grosor de la íntima-media carotídea tendió a progresar más rápidamente en pacientes que iniciaron tratamiento con darunavir/ritonavir. Sin embargo, la escala de riesgo cardiovascular de Framingham fue el único factor asociado con una mayor progresión tras ajustar por factores basales, lo que sugiere que, en esta población, a pesar de tener un riesgo cardiovascular bajo, los factores de riesgo cardiovascular tradicionales tendrían un papel más importante que el tratamiento antirretroviral recibido u otros factores asociados a la infección por VIH en la progresión de la enfermedad cardiovascular subclínica. No encontramos relación entre los niveles de bilirrubina y la progresión de ateromatosis subclínica. El cuarto estudio evalúa el impacto de la sustitución de fármacos inhibidores de la proteasa por dolutegravir en la salud cardiovascular, medida por la evolución de marcadores subrogados de enfermedad cardiovascular (ecografía carotídea y rigidez arterial) en pacientes con infección por VIH en tratamiento antirretroviral virológicamente suprimidos. La sustitución del inhibidor de proteasa por dolutegravir no mostró cambios significativos en el grosor de la íntima media carotídea. Sin embargo, se observó una tendencia a cambios favorables en pacientes con mayor riesgo cardiovascular o cuando cambiaban a partir de un inhibidor de proteasa diferente a darunavir o atazanavir, lo que sugiere que los pacientes con mayor riesgo cardiovascular podrían beneficiarse con esta estrategia de cambio de tratamiento. No observamos diferencias en los marcadores de función vascular entre las diferentes pautas de tratamiento antirretroviral en ninguno de los estudios. El quinto estudio evalúa la evolución de diferentes biomarcadores asociados a la patogénesis de la enfermedad cardiovascular en personas infectadas por VIH tras la sustitución de inhibidores de proteasa por dolutegravir. El cambio a dolutegravir se asoció a descensos en sCD14, PCRus y LDL-oxidada, lo que teóricamente comportaría un beneficio a nivel cardiovascular, pero también a un descenso de la adiponectina lo que tendría un efecto opuesto. Es probable que más allá del perfil lipídico de cada fármaco antirretroviral existan otras interacciones a nivel metabólico, de inflamación o de otro tipo, que comporten diferentes impactos en la salud cardiovascular de esta población. Los resultados encontrados sugieren que en el contexto actual, los factores de riesgo cardiovascular tradicionales pueden tener un papel fundamental en la progresión de ateromatosis subclínica más allá del tratamiento antirretroviral utilizado y de factores relacionados con el VIH., [eng] Cardiovascular disease is an increasing cause of morbidity among persons living with HIV. Traditional cardiovascular risk factors, antiretroviral treatment and factors directly linked to HIV infection such as immune depression, chronic inflammation and immune activation play a role in cardiovascular disease pathogenesis. Surrogate markers of subclinical atheromatosis, such as carotid ultrasonography or arterial stiffness measurements, are useful to study the impact of different factors on cardiovascular health. The main objective of this thesis is to study the factors that influence the cardiovascular health of people living with HIV infection and to evaluate the potential impact of different antiretroviral drugs, both at the metabolic level and on surrogate markers of subclinical atheromatosis. We compared the impact of darunavir/ritonavir vs. atazanavir/ritonavir as initial antiretroviral treatment on lipids, body composition and cardiovascular subclinical markers. No diferences in total, LDL and HDL cholesterol change were observed. However, there was a trend towards a lower total to HDL cholesterol ratio with atazanavir/ritonavir and this effect was unrelated to bilirubin. Atazanavir/ritonavir led to higher triglycerides and more total and subcutaneous fat, but not visceral fat, than darunavir/ritonavir. Also, fat gains with atazanavir/ritonavir were associated with insulin resistance. Patients on darunavir showed a trend to faster carotid intima media thickness progression than those on atazanavir. However, after adjustment in the multivariate analysis, a higher baseline Framingham score was the only factor associated with carotid intima media thickness progression. Then we evaluated the impact of antiretroviral switching on cardiovascular health and biomarkers in virologically suppressed HIV patients with high cardiovascular risk. Substitution of the protease inhibitor for dolutegravir did not show significant changes in the thickness of the carotid intima media. However, there was a trend for favorable changes in patients at increased cardiovascular risk or when switching from a protease inhibitor other than darunavir or atazanavir. We did not observe differences in vascular function markers between the different antiretroviral treatment regimens in any of the studies. Switching from protease inhibitor for dolutegravir was associated with decreases in sCD14, usCRP and oxidized LDL, which theoretically would entail a benefit at the cardiovascular level, but also with a decrease in adiponectin, which would have the opposite effect. Beyond the lipid profile of each antiretroviral drug there probably are other interactions at the metabolic, inflammatory or other level, that have different impacts on the cardiovascular health of this population. In summary, the results obtained suggest that traditional cardiovascular risk factors may play a more important role in subclinical atheromatosis progression than antiretroviral treatment or other factors related with HIV infection.

Introdução: O objetivo do estudo foi determinar os valores da espessura do complexo miointimal da carótida (CMIC) em pacientes que desenvolveram e não desenvolveram pré-eclâmpsia (PE) e determinar se os valores do CMIC poderiam ser preditores do desenvolvimento de PE. Métodos: O estudo incluiu gestantes examinadas por exame de ultrassonografia de rotina no Hospital Materno-Infantil Presidente Vargas (HMIPV) em Porto Alegre, Brasil, de abril de 2016 a setembro de 2017. As pacientes foram divididas em dois grupos. O primeiro grupo incluiu pacientes diagnosticadas com pré-eclâmpsia (n = 21) e o segundo grupo incluiu pacientes sem pré-eclâmpsia (n = 199). Um aparelho de ultrassom com transdutor de alta frequência (12 MHz) com método semiautomático foi utilizado para estimar o CMIC. Resultados: O CMIC foi significativamente maior em gestantes com PE do que em gestantes sem PE (0,55 ± 0,11 vs. 0,44 ± 0,06, respectivamente; p

INTRODUCTION: Cardiovascular diseases are one of the leading causes of mortality worldwide. It is known to have a reduced incidence in premenopausal women compared to the opposite sex. This appears to be related to the female hormones and their fluctuation throughout the menstrual cycle. Objectives: To evaluate and correlate behavior patterns of cerebral dynamics and arterial reactivity throughout the menstrual cycle and to identify possible differences caused by the use of oral contraceptives (OC). METHODS: The sample consisted of 21 healthy, eumenorrheic and non-smoking young womens, belonging to the 18-21 age group. There were two distinct groups: 11 in the group without oral contraceptive (SCO) and 10 in the oral contraceptive group (CCO). Both groups performed an evaluation in the menstrual phase (MP), from the 1st to the 4th day, and in the ovulatory phase (OP), from the 12th to the 16th day. The third evaluation was performed in the late luteal phase (LLP) from the 26th to the 30th day, in the SCO group and in the OC pause, from the 21st to the 28th day, in the CCO group. Four noninvasive procedures were performed: blood pressure measurement, axillary temperature, carotid and right brachial artery sonography. RESULTS: There were no statistically significant differences in carotid parameters, however, there were variations in the velocity of the systolic peak (VPS) of the common carotid artery (CCA) and internal carotid artery (ICA) and the ICA resistance index (IR), throughout the cycle. The SCO group showed a significant increase in FMD from MF to OF (p = 0.023), decreasing in LL (p = 0.012). The CCO group demonstrated a relative stabilization of FMD values. In OP, there were statistically significant differences between the two groups in relation to the FMD value (p = 0.040). CONCLUSIONS: Cyclic fluctuations of estrogen appear to influence cerebral vascular impedance and arterial reactivity but in different proportions. In conclusion, this study supports the idea of standardizing the timing of vascular testing in a premenopausal woman. info:eu-repo/semantics/publishedVersion

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Visual inspection of ultrasound examination for assessment of echogenicity and echotexture of blood vessel tissues is a technique routinely used in medical practice in humans. However, simple visual inspection can lead to poor quality diagnoses and errors. The use of grayscale histogram (GSH) analysis has proved to be an efficient technique to quantify the region of interest, allowing minimization of image interpretation errors. This study aimed to evaluate and compare the echogenicity and echotexture of the walls of the common carotid arteries of healthy female horses and mules using the GSH technique and correlate them with age, body mass, and vessel diameters. B-mode ultrasound examinations were performed in the left and right common carotid arteries in three regions (cranial, middle, and caudal) in 11 horses and 11 healthy mules. The GSH of the animals showed heterogeneous walls, but did not differentiate statistically between female horses and mules. The Mean variable of the middle right, middle left and caudal right sides showed differences, more significant in the mules. On the middle right side, the Min variable was different, higher in the mules. On the middle and caudal left side, the variables Max and Mode showed higher values in the mules. For the mules, the age factor presented negative correlation with the Mean, Mode,, Mode(Count), and Mode(Count)/Count(%) variables, and the body mass factor presented negative correlation with the Mode, Mean and Max variables. For the female horses, the body mass factor showed positive correlation with the Mean and Mode variables. Echogenicity of the carotid artery walls differed between female horses and mules, whereas echotexture was heterogeneous and statistically similar among the animals. The age and body mass factors inversely influenced the echogenicity of the mules, but were not significant in the female horses, in which only the body mass factor positively influenced echogenicity. RESUMO: A técnica de avaliação da ecogenicidade e ecotextura dos tecidos dos vasos sanguíneos por inspeção visual do exame de ultrassonografia, já é uma prática da rotina médica em humanos. No entanto, a simples visualização manual pode induzir à erros e diagnósticos de pouca qualidade. O uso de análise por histograma em escala de cinza (HEC) tem se demostrado uma eficiente técnica para quantificar a região avaliada, permitindo minimizar erros de interpretação. O objetivo deste trabalho foi avaliar e comparar a ecogenicidade e ecotextura das paredes das artérias carótidas comuns das fêmeas equina e muares hígidos usando a técnica de HEC, e correlacioná-las com a idade, massa corpórea e diâmetros dos vasos. Exames de ultrassonografia modo-B foram realizados nas artérias carótidas comuns esquerda e direita em três regiões (cranial, médio e caudal) em 11 fêmeas equina e 11 muares hígidos. O HEC dos animais apresentou paredes heterogêneas, mas não diferenciaram estatisticamente entre fêmeas equinas e muares. A variável Mean do lado direito médio, esquerdo médio e caudal apresentou diferenças, sendo maiores nos muares. No lado direito médio, o Min foi diferente, sendo superior nos muares. Já para o lado esquerdo médio e caudal, as variáveis Max e Mode apresentaram valores maiores nos muares. Para os muares, o fator idade apresentou correlação negativa com Mean, Mode, Mode (Count) e Mode(Count)/Count (%) e o fator massa corpórea apresentou correlação negativa com Mode, Mean e Max. Para as fêmeas equinas o fator massa corpórea apresentou correlação positiva com Mean e Mode. A ecogenicidade das paredes das artérias carótidas diferiram entre fêmeas equina e muares, já a ecotextura foi heterogênea e semelhante estatisticamente entre os animais. A idade e a massa corpórea influenciaram inversamente na ecogenicidade dos muares, enquanto que nas fêmeas equina a idade não foi significativa, apenas a massa corpórea influenciou positivamente com a ecogenicidade.

Subjects with levels of non-HDL-C 30 mg/dL above those of LDL-C (lipid discordance) or with high remnant cholesterol levels could have a greater residual cardiovascular risk.To determine the prevalence of lipid discordance in a primary prevention population and analyze the clinical variables associated with it; To investigate the association between lipid discordance and remnant cholesterol with the presence of carotid plaque.Primary prevention patients without diabetes or lipid-lowering therapy were included. Regardless of the LDL-C level, we define "lipid discordance" if the non-HDL-C value exceeded 30 mg/dL that of LDL-C. Remnant cholesterol was calculated as total cholesterol minus HDL-C minus LDL-C when triglycerides were4.0 mmol/L. Ultrasound was used to assess carotid plaque occurrence. Multiple regression logistic models were performed.The study included 772 patients (mean age 52 ± 11 years, 66% women). The prevalence of lipid discordance was 34%. Male sex and body mass index were independently associated with discordant lipid pattern. The prevalence of carotid plaque was higher in subjects with lipid discordance (40.2% vs. 29.2, p = 0.002). The multivariate analysis showed that the discordant lipid pattern was associated with the greater probability of carotid plaque (OR 1.58, 95% CI 1.08-2.34, p = 0.02). Similarly, a significant association between calculated remnant cholesterol and carotid plaque was found.Lipid discordance and presence of a higher level of calculated remnant cholesterol are associated with subclinical atherosclerosis. Our findings could be used to improve the residual cardiovascular risk evaluation.Indivíduos com níveis de não HDL-C excedendo em 30 mg/dl aqueles de LDL-C (discordância lipídica) ou com altos níveis de colesterol remanescente poderiam ter maior risco cardiovascular residual.determinar a prevalência de discordância lipídica em uma população de prevenção primária e analisar as variáveis clínicas com ela associadas; investigar a associação de discordância lipídica e colesterol remanescente calculado com a presença de placa carotídea.Pacientes de prevenção primária sem diabetes ou sem terapia hipolipemiante foram incluídos. Independentemente do nível de LDL-C, definiu-se "discordância lipídica" como um valor de não HDL-C excedendo em 30 mg/dl aquele de LDL-C. Calculou-se o colesterol remanescente como colesterol total menos HDL-C menos LDL-C na presença de triglicerídeos4,0 mmol/l. Usou-se ultrassom para avaliar a presença de placa carotídea. Modelos de regressão logística múltipla foram construídos.Este estudo incluiu 772 pacientes (idade média, 52 ± 11 anos; 66% mulheres). A prevalência de discordância lipídica foi de 34%. Sexo masculino e índice de massa corporal mostraram associação independente com padrão lipídico discordante. A prevalência de placa carotídea foi maior em indivíduos com discordância lipídica (40,2% vs. 29,2; p = 0,002). A análise multivariada mostrou associação do padrão lipídico discordante com maior probabilidade de placa carotídea (OR: 1,58; IC95%: 1,08-2,34; p = 0,02). Da mesma forma, identificou-se uma significativa associação entre colesterol remanescente calculado e placa carotídea.Discordância lipídica e presença de nível mais alto de colesterol remanescente calculado acham-se associados com aterosclerose subclínica. Nossos achados podem ser usados para aprimorar a avaliação de risco cardiovascular residual.

Background Restenosis after percutaneous coronary intervention in coronary heart disease remains an unsolved problem. Clusterin (CLU) (or Apolipoprotein [Apo] J) levels have been reported to be elevated during the progression of postangioplasty restenosis and atherosclerosis. However, its role in neointimal hyperplasia is still controversial. Objective To elucidate the role Apo J in neointimal hyperplasia in a rat carotid artery model in vivo with or without rosuvastatin administration. Methods Male Wistar rats were randomly divided into three groups: the control group (n = 20), the model group (n = 20) and the statin intervention group (n = 32). The rats in the intervention group were given 10mg /kg dose of rosuvastatin. A 2F Fogarty catheter was introduced to induce vascular injury. Neointima formation was analyzed 1, 2, 3 and 4 weeks after balloon injury. The level of Apo J was measured by real-time PCR, immunohistochemistry and western blotting. Results Intimal/medial area ratio (intimal/medial, I/M) was increased after balloon-injury and reached the maximum value at 4weeks in the model group; I/M was slightly increased at 2 weeks and stopped increasing after rosuvastatin administration. The mRNA and protein levels of Apo J in carotid arteries were significantly upregulated after rosuvastatin administration as compared with the model group, and reached maximum values at 2 weeks, which was earlier than in the model group (3 weeks). Conclusion Apo J served as an acute phase reactant after balloon injury in rat carotid arteries. Rosuvastatin may reduce the neointima formation through up-regulation of Apo J. Our results suggest that Apo J exerts a protective role in the restenosis after balloon-injury in rats.

BACKGROUND AND OBJECTIVES: Spinal manipulation (SM) can reduce or improve the pain and dizziness originated in the neck. However, there is some criticism against SM. The objective of this study was to check if the osteopathic manipulation (OM) with a cervical rhythmic articulatory technique (CRAT) provides oscillations of the blood flow velocity (BFV) in the internal carotid arteries (ICA), vertebral arteries (VA) and basilar artery (BA), and if this technique is a risk factor for this circulatory system. METHODS: The study was conducted with 73 individuals (men and women) with mechanical cervicalgia, with an average age of 37.7±6.4 years. Fifty-eight had mild to moderate pain, randomly divided into control group (CG) and experimental-1 (EG-1), and 15 with severe pain in the experimental-2 group (EG-2). All subjects were submitted to the artery ultrasound (ICA, VA, and BA) in a blind methodology for the tests 1 (E1) and 2 (E2). Between E1 and E2, one single OM-CRAT was performed in the EGs 1 and 2 and resting for the CG. RESULTS: In the EG-1 there was a slight reduction of the BFV in the right ICA. In the EG-2 there was a significant increase of the BFV in the right VA. All samples presented normality. In the CG there was a reduction of the BFV in the left VA. When comparing the three groups, there was significance for the CG as EG-2 of the BFV in the right ICA (in E1) and of the BFV in the left ICA (in E2). CONCLUSION: Despite the BFV oscillations, one can conclude that the OM-CRAT generates oscillation in the BFV within the normality parameters and it is not a risk factor for cerebral circulation. RESUMO JUSTIFICATIVA E OBJETIVOS: A manipulação vertebral cervical (MVC) pode reduzir ou melhorar a dor e a tontura de origem cervical. No entanto, há críticas contra a MVC. O objetivo deste estudo foi verificar se a manipulação osteopática (MO) com técnica articulatória rítmica cervical (TARC) proporciona oscilações de velocidade de fluxo sanguíneo (VFS) nas artérias carótidas internas (ACI), vertebrais (AV) e basilar (AB), e se essa técnica é um fator de risco para esse sistema circulatório. MÉTODOS: A casuística foi constituída de 73 indivíduos (homens e mulheres) com cervicalgia mecânica, com idade média de 37,7±6,4 anos, sendo 58 com dor leve a moderada, divididos por aleatorização em grupos controle (GC) e experimental-1 (GE-1), e 15 com dor intensa no grupo experimental-2 (GE-2). Todos foram submetidos à ultrassonografia arterial (em ACI, AV e AB) em metodologia encoberta para os exames 1 (E1) e 2 (E2). Entre E1 e E2 foi realizado única MO-TARC para os GE 1 e 2, e repouso para o GC. RESULTADOS: Em GE-1 houve pequena redução de VFS da ACI direita. Em GE-2 houve aumento significativo de VFS na AV direita. Todas as amostras apresentaram normalidade. Em GC houve redução de VFS da AV esquerda. No comparativo entre os três grupos houve significância para o GC como GE-2 na VFS da ACI direita (em E1) e na VFS da ACI esquerda (em E2). CONCLUSÃO: Apesar das oscilações de VFS, concluiu-se que a MO-TARC gera oscilação de VFS dentro dos parâmetros de normalidade e não é um fator de risco para a circulação cerebral.

Atherosclerosis is a pathology of great importance worldwide, because of its direct relationship with cerebrovascular events, resulting in high morbidity and mortality rates. The possibility of atheromas being identified by means of panoramic radiography is consolidated in literature; however, limitations have been reported. Thus, the aim of the present clinical case was to demonstrate the possibility of using Manzi’s Projection, which is a technique that enables visualization of the carotid artery trajectory without superimpositions of other anatomic structures, capable of promoting differential diagnosis of calcified atheromas in the carotid artery during dental exams. RESUMO A aterosclerose representa uma patologia de grande importância mundial devido à relação direta com as doenças cerebrovaculares, resultando em altos índices de morbimortalidade. A possibilidade de identificação destas placas ateromatosas através da radiografia panorâmica está consolidada na literatura, sendo também relatadas suas limitações. Com intutito de possibilitar um diagnóstico diferencial de ateromas na prática odontológica, a Projeção de Manzi consiste numa técnica ântero-posterior que possibilita uma visualização sem sobreposições do trajeto carotídeo. O presente estudo tem por objetivo relatar um caso clínico demonstrando as possibilidades diagnósticas dos exames odontológicos na detecção de ateromas calcificados na artéria carótida.

Background Stroke remains the leading cause of morbidity and mortality in Brazil. Epidemiological data suggest that 10% to 30% of all strokes are due to atherosclerotic carotid artery disease and 8% due to vertebral artery disease. Endovascular treatment of extracranial lesions is an alternative to endarterectomy. We evaluated the results and predictors of adverse events in patients undergoing carotid and vertebral artery stenting. Methods Asymptomatic patients with lesion > 70% or symptomatic patients with lesions > 50% in carotid arteries and symptomatic patients with lesion > 70% in vertebral arteries were included. We evaluated the primary endpoint, defined as the composite incidence of death (procedural or non-procedural), major stroke, minor stroke or myocardial infarction (MI). Results Two hundred and twenty-four interventions with stenting were performed in 199 consecutive patients with a prevalence of males (73.9%), 69.8 ± 9.9 years of age and 37.7% were diabetics. Symptomatic patients represented about two thirds of the cases and the most commonly treated lesions were de novo lesions (96.4%). The left (46%) and right (44.6%) internal carotid arteries were the most commonly approached vessels. Composite primary endpoint was observed in 5% of the patients, procedure-related mortality in 1%, non-procedure related mortality in 1%, minor stroke in 1.5% and MI in 1.5%. Patients with a history of coronary artery disease had a 4-fold probability of presenting the primary endpoint [odds ratio (OR) 4.32, 95% confidence interval (CI 95%) 1.09-17.21); P = 0.038]. Conclusions In our study we obtained a high success rate and had a low rate of adverse events, demonstrating the safety and efficacy of percutaneous stent implantation in the carotid and vertebral arteries.

Background: Carotid intima-media thickness (C-IMT) is a reliable predictor of cardiovascular events. We Investigated the relationship between markers of glycemia and C-IMT in intermediate-risk cardiovascular patients. Methods: This study analyzed 427 subjects, aged 35 to 74 years (mean, 60.3 +/- 8.5 years), 55 % women, enrolled into the MARK study. Including 231 subjects defined as normal glucose, 104 subjects classified as prediabetes and 92 with type 2 diabetes mellitus. Carotid ultrasound was used to measure C-IMT and the presence of plaques. Fasting plasma glucose (mg/dl) and glycated hemoglobin (%) (HbA1c) were measured using standard enzymatic automated methods. Postprandial glucose (mg/dl) was self-measured by patients at home 2 h after meals (breakfast, lunch and dinner) for 1 day. Results: The C-IMT shows a positive correlation with fasting plasma glucose, postprandial glucose and HbA1c. Multiple linear regression analysis showed a positive association between HbA1c and C-IMT, with a 0.016 mm and 0.019 mm increase in mean and maximum C-IMT per 1 % increase in HbA1c. In addition, an association between fasting plasma glucose and C-IMT was found with an increase of 0.004 and 0.005 mm in mean and maximum C-IMT per 10 mg/dl in fasting plasma glucose. We also observed a graded association between fasting plasma glucose, postprandial glucose and HbA1c and the presence of carotid target organ damage (TOD), with an odds ratio of 1.013, 1.010 and 1.425, respectively. Conclusion: The results of this study suggest that the fasting plasma glucose and HbA1c, but not postprandial glucose, are associated with C-IMT media and maximum. The patients who present with a metabolic glucose alteration have more risk of developing carotid TOD., This work was supported by grants from the Spanish Ministry of Science and Innovation (MICINN), the Carlos III Health Institute/European Regional Development Fund (ERDF) (MICINN, ISCIII/FEDER) (Red RedIAPP RD12/0005, Research Groups: RD12/0005/0004, RD12/0005/0002, RD12/0005/0011), the Health Research Fund (PI10/01088, PI10/02077, PI10/02043), and the Regional Health Management of the Castilla and Leon (GRS 635/A/11; GRS 906/B/14).

O estudo tem por objetivo avaliar a associação entre periodontite crônica e a espessura da camada íntima-média da artéria carótida comum, aterosclerose e marcadores de risco para doença cardiovascular. Este estudo observacional transversal foi realizado com uma amostra de 93 pacientes de ambos os sexos do Pronto Socorro Cardiológico Universitário de Pernambuco (PROCAPE). Todos pacientes realizaram anamnese e avaliação periodontal. Foram obtidos índice de placa, índice de sangramento, recessão gengival e profundidade de sondagem em seis sítios por dente. A medida da espessura da camada íntima- média da artéria carótida (EIMC) e a presença de placa de ateroma foram determinadas por meio de ultrassonografia. Taxas de glicemia, hemoglobina glicada, triglicerídeos, colesterol total, LDL, HDL e proteína C reativa foram obtidas através de exames laboratoriais anexados aos prontuários dos pacientes. Dos 93 pacientes, com idade de média de idade de 59,3 anos (19 a 82 anos), 74,2% apresentaram periodontite crônica e 11,8% gengivite. Pacientes sem periodontite ou com periodontite crônica leve apresentaram EIMC menor (0,90mm) em relação aos que tinham periodontite crônica moderada (1,09mm; p= 0,002) e severa (1,11mm; p= 0,002). A presença de placas de ateroma foi maior em pacientes com periodontite crônica moderada e severa (p= 0,04). Em relação aos parâmetros periodontais, médias de profundidades de sondagem >3mm aumentaram em 11 vezes a chance de ter um EIMC > 1mm. Em relação aos marcadores inflamatórios, 46,3% dos pacientes com taxa de proteína C reativa até 1mg/dL apresentaram perda de inserção clínica > 4mm, 90,9% daqueles com proteína C reativa >1mg/dL apresentaram perda de inserção >4mm (p= 0,005). Na população estudada, houve correlação estatisticamente significante entre periodontite crônica, aumento na EIMC e presença de placa de ateroma, mas essa relação não foi mantida na análise multivariada. A profundidade sondagem foi relacionada significativamente com o aumento da espessura da camada íntima-média da artéria carótida comum, e os índices de sangramento à sondagem e a perda de inserção clínica foram associadas a maiores taxas de proteína C reativa. The objective of this study was to evaluate the association between chronic periodontitis and the thickness of the intima-media layer of the common carotid artery, atherosclerosis, and risk markers for cardiovascular disease. This cross-sectional observational study was performed with a sample of 93 patients of both genders from the Pernambuco University Cardiovascular Emergency (PROCAPE). All patients underwent anamnesis and periodontal evaluation. Plaque index, bleeding index, gingival recession and probing depth were obtained in six sites per tooth. Measurement of carotid artery intima-media thickness (IMT) and the presence of atheroma plaque were determined by ultrasonography. Rates of glycemia, glycated hemoglobin, triglycerides, total cholesterol, LDL, HDL, and C-reactive protein were obtained through laboratory tests attached to patient charts. Of the 93 patients, with an average age of 59.3 years (19 to 82 years), 74.2% had chronic periodontitis and 11.8% had gingivitis. Patients without periodontitis or mild chronic periodontitis presented lower IMT (0.90mm) than those who had moderate chronic periodontitis (1.09mm; p = 0.002) and severe (1.11mm; p = 0.002). The presence of atheroma plaques was higher in patients with moderate and severe chronic periodontitis (p = 0.04). Regarding periodontal parameters, mean probing depth> 3mm increased by 11 times the chance of having an IMT> 1mm. Regarding inflammatory markers, 46.3% of the patients with C-reactive protein levels up to 1mg / dL had a clinical attachment loss> 4mm, 90.9% of those with C-reactive protein> 1mg / dL presented attachment loss> 4mm P = 0.005). In the studied population, there was a statistically significant correlation between chronic periodontitis, an increase in IMT and the presence of atheroma plaque, but this relationship was not maintained in the multivariate analysis. The probing depth was significantly related to the increase in the thickness of the intima-media layer of the common carotid artery, and bleeding on probing indices and clinical attachment loss were associated with higher rates of C-reactive protein.

Trabalho final de mestrado integrado em Medicina área científica de Acupunctura, apresentado á Faculdade de Medicina da Universidade de Coimbra Introdução: O sistema nervoso autónomo (sistema nervoso simpático e parassimpático) é responsável pela homeostasia corporal, regulando funções fundamentais, nomeadamente a circulação. Diversos estudos demonstram o potencial efeito terapêutico da acupunctura em diversas patologias, como no alívio da dor crónica e nos distúrbios do sistema músculoesquelético. Todavia não existe concordância quanto aos seus efeitos benéficos na reabilitação do acidente vascular cerebral (AVC). Crê-se que os efeitos da acupunctura possam resultar de vários mecanismos neurais e hormonais, promovendo um estímulo sensorial ativando diversas vias e alterando, consequentemente, numerosos sistemas, interferindo com a rede vascular através da libertação de estímulos que podem ter uma ação vasomotora. Este trabalho pretende demonstrar se existe ou não vasodilatação dos vasos carotídeos com consequente aumento do fluxo sanguíneo cerebral. Materiais e Métodos: Em 2 grupos, 20 voluntários do sexo feminino e 10 do sexo masculino, foi feita a avaliação funcional das artérias carotídeas com recurso a eco-doppler carotídeo, que consiste numa avaliação ultrassonográfica do fluxo sanguíneo dentro das artérias carotídeas, possibilitando detetar alterações no seu lúmen. Esta avaliação foi efetuada antes da colocação das agulhas (0 minutos) e após 10, 15 e 20 minutos da colocação das agulhas, utilizando os pontos 07CO (Shénmén), 03CO (Shàohăi) e 06PE (Nèiguān) bilateralmente, 20DU (Băihuì) e Yintang. Na análise estatística dos resultados recorreu-se ao programa SPSS na versão 21.0. Resultados: Na amostra do sexo feminino não se verificaram alterações significativas no Índice de Resistência Carotídea (IRC), quer à direita quer à esquerda. Na amostra do sexo masculino não se verificou uma diminuição significativa do IRC à direita, mas verificou-se uma diminuição significativa no valor da média do IRC à esquerda de T1 para o T2 [.7830 ± .04523 (.7600 – .8150) vs .7530 ± .06001 (.7225 – .7925) Z=-2.572 p=.010)], bem como uma diminuição significativa do IRC do T0 para o T2 [.7980 ± .04367 (.7775 – .8200) vs .7530 ± .06001 (.7225 – .7925) Z=-2,094 p=.036)]. Discussão: Na amostra do sexo masculino, houve diminuição significativa do IRC no lado esquerdo entre os 0 e 15 minutos, sendo esta diminuição mais elevada entre os 10 e 15 minutos, sem alteração significativa no lado direito. Estes resultados podem estar parcialmente relacionados com os resultados obtidos por uma investigação retrospetiva que sugere que as velocidades de fluxo carotídeas e a hemodinâmica cardíaca estão significativamente relacionados apenas do lado esquerdo, provavelmente devido a maior stress hemodinâmico. São necessários estudos com amostras de maiores dimensões e seria relevante fazer mais trabalhos com esta metodologia que comparassem indivíduos saudáveis com indivíduos com patologia aterosclerótica isquémica Introduction: The autonomic nervous system (sympathetic and parasympathetic nervous system) is responsible for body homeostasis, by regulating basic functions such as circulation. Several studies have shown acupuncture’s therapeutic effect in diverse pathologies, including chronic pain relief e musculoskeletal system disorders. However there is no conformity as to whether acupuncture is beneficial in stroke rehabilitation. It is believed that acupuncture effects can result from neural and hormonal mechanisms, by promoting sensorial stimuli and thus activating pathways which can subsequently change numerous systems. Vasomotor reaction can be established by interfering with the vascular network through stimuli release. Based on this premise, it is intended to demonstrate whether there is in fact carotid vasodilation with cerebral blood flow increase. Materials and methods: Carotid artery functional assessment was made in two separate groups, one with twenty female volunteers and another with ten male volunteers, using Doppler ultrasound, which is a sonographic technique to evaluate blood flow within a vessel, thus detecting any alterations. This assessment was made before needle puncture (0 minutes) and after 10, 15 and 20 mintutes, using acupuncture points 07HT (Shénmén), 03HT (Shàohăi) and 06PC (Nèiguān) bilaterally, 20DU (Băihuì) and Yintang. SPSS Version 21.0 was used in the results statistical analysis. Results: Carotid resistance index (CRI) showed no significant changes in the female sample, in both left and right sides. In the male sample, there is a significant reduction in CRI value from T1 to T2 [.7830 ± .04523 (.7600 – .8150) vs .7530 ± .06001 (.7225 – .7925) Z=-2.572 p=.010)]. Similarly, average CRI comparison shows a significant reduction of T0 to T2 [.7980 ± .04367 (.7775 – .8200) vs .7530 ± .06001 (.7225 – .7925) Z=-2,094 p=.036)] and in the right side there was no significant reduction of CRI. Discussion: In the male sample, there was significant index decrease in the left side between 0 and 15 minutes, the higher decrease in the range of 10 and 15 minutes, with no significant change in the right side. This results can be partially related to results obtained by a retrospective investigation who suggests that carotid flow speed and cardiac hemodynamic were significantly related only in the left side, probably due to greater hemodynamic stress. Large methodologically-sound trials are required and it is advisable to use this method in studies which compare healthy subjects with those with ischemic atherosclerotic pathology

OBJETIVO: Identificar a prevalência de estenose carotídea (EC) e os possíveis preditores de mortalidade em indivíduos submetidos à cirurgia de revascularização miocárdica (CRM) eletiva. MÉTODOS: Estudo de coorte que incluiu 393 candidatos à CRM. Todos os pacientes realizaram ultrassonografia com Doppler em cores de artérias carótidas antes da CRM e foram seguidos durante a internação quanto à morbidade e mortalidade. A EC foi considerada clinicamente relevante quando > 50%. Um p < 0,05 foi considerado significativo. Regressão logística foi realizada para definir preditores independentes de mortalidade. RESULTADOS: A prevalência de EC foi de 17,4%. Após regressão logística, EC > 50% (p = 0,001) e insuficiência renal crônica (IRC) (p = 0,03) foram preditores, independentes de mortalidade. CONCLUSÃO: EC mostrou ter uma prevalência elevada na amostra estudada e, conjuntamente com a IRC, foi preditor, independente de mortalidade.OBJECTIVE: To identify carotid stenosis (CS) prevalence and potential mortality predictors in individuals undergoing elective coronary artery bypass grafting (CABG). METHODS: Cohort study including 393 scheduled for CABG. All patients underwent a color Doppler ultrasound study of the carotid arteries prior to CABG and were assessed for morbidity and mortality over the hospitalization. CS was considered clinically relevant when if > 50%. Significance was set at p < 0.05. Logistic regression was used to define mortality independent predictors. RESULTS: CS prevalence was 17.4%. Following logistic regression analysis, CS > 50% (p = 0.001) and chronic renal failure (CRF) (p = 0.03) remained as mortality independent predictors. CONCLUSION: CS showed a high prevalence in the study sample and together with CRF was a mortality independent factor.

OBJETIVO: Estudar os resultados da técnica descrita por Carreira et al. com utilização de perfusão cerebral seletiva bilateral (PCSAB) pelo isolamento do tronco braquiocefálico e artéria carótida esquerda. MÉTODOS: Quinze pacientes foram operados consecutivamente entre de junho de 2005 e setembro de 2007. Os dados foram analisados por programa informatizado Epi Info e significância estatística com p0,05). CONCLUSÃO: A técnica de PCSAB é reprodutível e apresenta resultados semelhantes aos da literatura mundial. A excelente evolução neurológica e o fácil controle de sangramentos nas linhas de sutura podem ter contribuído com os resultados obtidos. OBJECTIVE: To evaluate the results of a technique described by Carreira et al. using bilateral antegrade selective cerebral perfusion by isolating the brachiocephalic trunk and the left carotid artery. METHODS: Fifteen patients were operated between June 2005 and September 2007. Data analysis were performed using Epi Info and statistical significance was set at p0.05). CONCLUSION: The technique of bilateral selective cerebral perfusion described by Carreira et al. can be performed by others and presents similar results to the international literature. The excellent neurological outcome and easy bleeding control on surgical sutures lines are the major advantages of this new procedure.

Trabalho Final do Curso de Mestrado Integrado em Medicina, Faculdade de Medicina, Universidade de Lisboa, 2016 Submitted by Biblioteca da Faculdade de Medicina da Universidade de Lisboa (repositorio@medicina.ulisboa.pt) on 2017-04-11T13:48:42Z No. of bitstreams: 1 JoanaNRoque.pdf: 8851424 bytes, checksum: 75c17d8e1ca6d6b4296a433324616bc9 (MD5) Made available in DSpace on 2017-04-11T15:25:07Z (GMT). No. of bitstreams: 1 JoanaNRoque.pdf: 8851424 bytes, checksum: 75c17d8e1ca6d6b4296a433324616bc9 (MD5) Previous issue date: 2016

RESUMENPara guiar el tratamiento preventivo se utilizan distintas tablas de estimación de riesgocoronario. Por otro lado, las alteraciones de la pared arterial son una manifestación deaterosclerosis subclínica y su detección mediante ecografía puede emplearse para predecireventos coronarios.ObjetivoComparar la prevalencia de aterosclerosis subclínica evaluada mediante ecografía carótidofemoralentre grupos de bajo riesgo definidos por diferentes tablas.Material y métodosSe estudiaron 151 pacientes dislipidémicos con edad de 53 ± 12 años (rango: 20-82 años;45% varones), índice de masa corporal: 26 ± 3 kg/m2, 42% hipertensos, 17% tabaquistas y3% diabéticos a los que se les realizaron ecografías carótido-femorales y que calificaron paraevaluación de riesgo. Se calculó el riesgo individual mediante diferentes tablas de estimaciónde riesgo y se incluyeron los individuos con riesgo coronario estimado menor del 10% adiez años. Se excluyeron del análisis los pacientes con riesgo moderado y alto. Se definióaterosclerosis subclínica a la presencia de placas ateroscleróticas en la ecografía arterial. Secomparó la prevalencia de aterosclerosis subclínica entre los grupos de bajo riesgo.ResultadosUno de cada dos pacientes considerados de bajo riesgo presentó aterosclerosis subclínica,independientemente de la tabla utilizada. No hubo diferencias significativas en la prevalenciade aterosclerosis subclínica entre subgrupos. El 73% de los pacientes fueron categorizadosde bajo riesgo por ATP III y el 78% por AHA/ACC, en comparación con el 45% calculado porEuropea II (p < 0,001).ConclusionesLa ecografía carótido-femoral complementa la evaluación realizada mediante tablas de riesgoen la toma de decisiones terapéuticas en prevención primaria.

Made available in DSpace on 2015-10-06T13:02:37Z (GMT). No. of bitstreams: 0 Previous issue date: 2015-01-16. Added 1 bitstream(s) on 2015-10-06T13:19:40Z : No. of bitstreams: 1 000847520_20160120.pdf: 125282 bytes, checksum: c5aa36578924d7b8ee5b6a5975361246 (MD5) Bitstreams deleted on 2016-01-22T12:10:21Z: 000847520_20160120.pdf,. Added 1 bitstream(s) on 2016-01-22T12:10:56Z : No. of bitstreams: 1 000847520.pdf: 1274871 bytes, checksum: 8c9c67689d005bfad1504a2df6ddeaa4 (MD5) Conselho Nacional de Desenvolvimento Científico e Tecnológico (CNPq) A artéria carótida comum em equinos se trifurca com algumas variações anatômicas e é o principal vaso que fornece sangue arterial para o cérebro, sendo que é conhecido que sua oclusão causa lesões encefálicas em ratos e humanos. Há muito pouca literatura a respeito de estudos anatômicos e ultrassonográficos desse vaso nessa espécie. Esse estudo avaliou a artéria carótida comum de 50 equinos da raça Quarto de Milha em diferentes idades, divididos em três grupos (grupo I: >2anos, n=14; grupo II: 3-10 anos, n=21; grupo III 15-30 anos, n=15), e obteve valores de referencia para espessura intima-media (EIM), índice de resistividade (IR), índice de pulsatilidade (IP) e diâmetro para ambas artérias carótidas comuns. Os exames foram feitos utilizando um transdutor de 18 MHz no sulco jugular, na altura de C5-C6. O diâmetro esquerdo médio foi de 8,71 ± 1,09 mm para o grupo I; 10,11 ± 0,72 mm para o grupo II e 10,72 ± 0,96 mm para o grupo III. O diâmetro direito médio foi de 8,92 ± 1,24 mm para o grupo I; 10,96 ± 1,06 mm para o grupo II e 11,76 ± 1,07 mm para o grupo III. A EIM foi de 0,90 ± 0,15 mm; 1,02 ± 0,09 mm e 0,97 ± 0,10 mm para os grupos I, II e III, respectivamente. Os valores médios de IR e IP obtidos foram 0,75 ± 0,07 e 1,63 ± 0,33 para o grupo I; 0,81 ± 0,06 e 2,08 ± 0,46 para o grupo II; 0,90 ± 0,10 e 3,20 ± 0,74 para o III, respectivamente. As variáveis IR, IP e EIM não são influenciadas por sexo ou lado, mas sim por idade. Já o diâmetro está correlacionado com o lado e idade, sendo sempre maior do lado direito Common carotid artery in horses trifurcates with some anatomical variations and it is the main supply of arterial blood to the brain. It is known that carotid occlusion can cause encephalic lesions in rats and humans. There are few studies on this vessel, including ultrasonografic evaluation of his vessel in this species. This study evaluated the common carotid artery in 50 American Quarter horses with different ages, separated into three groups (group I: >2years, n=14; group II: 3-10 years, n=21; group III 15-30 years, n=15), and reference values for intima-media thickness (IMT), resistivity index (RI), pulsatility index (PI) and diameter were obtained for both arteries. Exam was performed using an 18 MHz transducer on jugular groove, on level of C5-C6. Mean left diameter was 8.71 ± 1.09 mm for group I; 10.11 ± 0.72 mm for group II and 10.72 ± 0.96 mm for group III. Right diameter was 8.92 ± 1.24 mm for group I; 10.96 ± 1.06 mm for group II and 11.76 ± 1.07 mm for group III. IMT was 0.90 ± 0.15 mm; 1.02 ± 0.09 mm and 0.97 ± 0.10 mm for groups I, II and III, respectively. Mean RI and PI obtained were 0.75 ± 0.07 and 1.63 ± 0.33 for group I; 0.81 ± 0.06 and 2.08 ± 0.46 for group II; 0.90 ± 0.10 and 3.20 ± 0.74 for group III, respectively. The variables RI, PI and IMT are not influenced by gender or side, but were by age. Diameter was influenced by both, age and side, and right diameter was always greater than the left

Objectives To determine the influence of the pulse repetition frequency (PRF) and wall motion filter on the 3-dimensional (3D) power Doppler vascularization-flow index (VFI) and volumetric pulsatility index (PI) obtained from spatiotemporal image correlation (STIC) data sets acquired from a common carotid artery of a healthy participant. Methods We acquired 11 STIC data sets, 1 for each PRF value ranging from 0.6 to 9.0 kHz. Vascularization-flow index and volumetric PI values were determined from the 440 static 3D data sets contained in these STIC data sets. Additionally, 3 sets of radio-frequency data were acquired for offline processing of different wall motion filter values for PRF values of 0.6, 3.3, and 10 kHz. Results We constructed VFI curves and observed 2 patterns: a flattened pattern with a low PRF and a triphasic pattern with a high PRF, correlating with the known pulsed wave Doppler profile of this vessel. Volumetric PI values were around 0 for low PRF settings and increased with increasing PRF. Analysis of the radiofrequency data showed that increasing wall motion filter values gradually filtered out the low-velocity power Doppler signals while retaining the higher-velocity ones, allowing the distinction of integrated power Doppler signal velocity throughout the cardiac cycle. Conclusions We conclude that the PRF and wall motion filter dramatically influence 3D power Doppler indices and the volumetric PI, and the use of PRF values in which minimum VFI values are measured during the diastolic phase in the spectral Doppler wave may validate the use of the volumetric PI.

This study aimed to analyzing the effect of chronic sodium overload upon carotid and femoral injury, and its relation to vascular angiotensin modulation. Male C57Bl6 mice were divided in: control (cont), receiving 1% NaCl solution for 2 weeks (salt-2) or 12 weeks (salt-12). Two-weeks before the end of the study, a 2mm catheter was implanted around the left femoral and carotid arteries to induce injury. Blood pressure (BP) and heart rate (HR) were measured at the end of the study by tail plethysmography. Arteries were collected and prepared for histological analysis to determine arterial thickening and perivascular collagen deposition. Angiotensin II and Ang(1-7) were quantified in fresh arteries using the HPLC method. There were no differences in body weight, BP and HR. Intima/media ratio had a similar increase in both injured arteries of cont and salt-2 mice, but a more pronounced increase was observed in salt-12 mice (31.1±6%). On the other hand, sodium overload modified perivascular collagen deposition, increasing thick fibers (cont: 0.5%; salt-2: 3.4%; salt-12: 0.6%) and decreasing thin fibers (cont: 7.4%; salt-2: 0.5%; salt-12: 6.8%) in non-injured arteries. Injured arteries presented similar collagen fiber distribution. Angiotensin quantification showed increased Ang(1-7) in salt treated mice (salt-2: +72%; salt-12: +45%) with a concomitant decrease in Ang II (salt-2: -54%; salt-12: -60%). Vascular injury increased significantly Ang(1-7) in salt-12 mice (+80%), maintaining Ang II reduction similar to that of a non-injured artery. The lack of changes in BP and HR suggests that the structural changes observed may be due to non-hemodynamic mechanisms such as local renin-angiotensin system. Collagen evaluation suggests that sodium overload induces time-related changes in vascular remodeling. The increase of artery injury with concomitant increase in Ang(1-7) in 12-week treated mice shows a direct association between the duration of salt treatment and the magnitude of vascular injury.