Carotid Atherosclerosis and White Matter Hypodensities: a Controversial Relationship
Autor(a) principal: | |
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Data de Publicação: | 2014 |
Outros Autores: | , , , , , , , |
Tipo de documento: | Artigo |
Idioma: | por eng |
Título da fonte: | Repositório Científico de Acesso Aberto de Portugal (Repositórios Cientìficos) |
Texto Completo: | https://www.actamedicaportuguesa.com/revista/index.php/amp/article/view/5100 |
Resumo: | Introduction: White matter hypodensities of presumed vascular origin, are recognized as an important cause of morbidity with established clinical and cognitive consequences. Nonetheless, many doubts remain on its physiopathology. Our goal is to clarify the potential role of carotid atherosclerosis and other vascular risk factors in the development of white matter hypodensities of presumed vascular origin.Material and Methods: We included patients that underwent CT brain scan and neurosonologic evaluation within a one-month period. Full assessment of vascular risks factors was performed. We seek to find independent associations between white matter hypodensities of presumed vascular origin, carotid intima-media thickness and vascular risk factors.Results: 472 patients were included, mean age was 67.32 (SD: 14.75), 274 (58.1%) were male. The independent predictors of white matter hypodensities of presumed vascular origin were age (OR: 1.067, 95% IC: 1.049 – 1.086, p < 0.001) and hypertension (OR: 1.726, 95% IC: 1.097 – 2.715, p = 0.018). No association was found between IMT (OR: 2.613, 95% IC: 0.886 – 7.708, p = 0.082) or carotid artery stenosis (OR: 1.021, 95% IC: 0.785 – 1.328, p = 0.877) and white matter hypodensities of presumed vascular origin.Discussion: Only age and hypertension proved to have an independent association with white matter hypodensities of presumed vascular origin. Carotid atherosclerosis, evaluated by IMT and the degree of carotid artery stenosis, showed no association with white matter hypodensities of presumed vascular origin. Since atherosclerosis is a systemic pathology, these results suggest that alternative mechanisms are responsible for the development of white matter hypodensities of presumed vascular origin.Conclusion: Age and hypertension seem to be the main factors in the development of white matter hypodensities of presumed vascular origin. No association was found between carotid atherosclerosis and white matter hypodensities of presumed vascular origin.Keywords: Brain; Carotid Artery Disease. |
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Carotid Atherosclerosis and White Matter Hypodensities: a Controversial RelationshipAterosclerose Carotídea e Hipodensidades da Substância Branca: uma Relação ControversaIntroduction: White matter hypodensities of presumed vascular origin, are recognized as an important cause of morbidity with established clinical and cognitive consequences. Nonetheless, many doubts remain on its physiopathology. Our goal is to clarify the potential role of carotid atherosclerosis and other vascular risk factors in the development of white matter hypodensities of presumed vascular origin.Material and Methods: We included patients that underwent CT brain scan and neurosonologic evaluation within a one-month period. Full assessment of vascular risks factors was performed. We seek to find independent associations between white matter hypodensities of presumed vascular origin, carotid intima-media thickness and vascular risk factors.Results: 472 patients were included, mean age was 67.32 (SD: 14.75), 274 (58.1%) were male. The independent predictors of white matter hypodensities of presumed vascular origin were age (OR: 1.067, 95% IC: 1.049 – 1.086, p < 0.001) and hypertension (OR: 1.726, 95% IC: 1.097 – 2.715, p = 0.018). No association was found between IMT (OR: 2.613, 95% IC: 0.886 – 7.708, p = 0.082) or carotid artery stenosis (OR: 1.021, 95% IC: 0.785 – 1.328, p = 0.877) and white matter hypodensities of presumed vascular origin.Discussion: Only age and hypertension proved to have an independent association with white matter hypodensities of presumed vascular origin. Carotid atherosclerosis, evaluated by IMT and the degree of carotid artery stenosis, showed no association with white matter hypodensities of presumed vascular origin. Since atherosclerosis is a systemic pathology, these results suggest that alternative mechanisms are responsible for the development of white matter hypodensities of presumed vascular origin.Conclusion: Age and hypertension seem to be the main factors in the development of white matter hypodensities of presumed vascular origin. No association was found between carotid atherosclerosis and white matter hypodensities of presumed vascular origin.Keywords: Brain; Carotid Artery Disease.Introdução: As hipodensidades da substância branca de provável etiologia vascular, são uma causa importante de morbilidade, condicionando deterioração cognitiva. No entanto, numerosas dúvidas persistem quanto à sua fisiopatologia. O objectivo deste estudo é clarificar o papel da aterosclerose carotídea e outros factores de risco vascular no desenvolvimento das hipodensidades da substância branca de provável etiologia vascular.Material e Métodos: Realizou-se uma avaliação imagiológica, por tomografia computadorizada crânio-encefálica e ecografia carotídea, com menos de um mês de intervalo. Procedeu-se à recolha de informação sobre os factores de risco vascular. Determinámos associações independentes entre hipodensidades da substância branca de provável etiologia vascular, espessura da íntima média carotídea, estenose carotídea ateromatosa e factores de risco vascular.Resultados: Foram incluídos 472 doentes, idade média de 67,32 (DP: 14.75), 274 (58,1%) sexo masculino. Os preditores independentes da hipodensidades da substância branca de provável etiologia vascular foram: idade (OR: 1,067, 95% IC: 1,049 – 1,086, p < 0,001) e a hipertensão (OR: 1,726, 95% IC: 1,097 – 2,715, p = 0,018). Não foi encontrada uma associação entre a espessura da intima média carotídea (OR: 2,613, 95% IC: 0,886 – 7,708, p = 0,082) ou grau de estenose carotídea (OR: 1,021, 95% IC: 0,785 – 1,328, p = 0,877) e hipodensidades da substância branca de provável etiologia vascular.Discussão: Dos diversos factores de risco analisados, apenas a idade e hipertensão se associaram de forma independente às hipodensidades da substância branca de provável etiologia vascular. Não foi encontrada uma relação entre a aterosclerose extracraniana, expressa pela espessura do complexo intima-média ou grau de estenose, com o desenvolvimento de hipodensidades da substância branca de provável etiologia vascular. Sendo a aterosclerose um fenómeno sistémico, estes achados sugerem que as hipodensidades da substância branca de provável etiologia vascular, tenham um mecanismo alternativo ou concorrente à aterosclerose no seu desenvolvimento.Conclusão: Os dados deste estudo, sugerem que a idade e hipertensão sejam os principais factores de risco no desenvolvimento de hipodensidades da substância branca de provável etiologia vascular. Não foi encontrada uma associação independente entre a aterosclerose carotídea e as hipodensidades da substância branca de provável etiologia vascular.Palavras-chave: Cerébro; Doença Carotídea.Ordem dos Médicos2014-09-25info:eu-repo/semantics/publishedVersioninfo:eu-repo/semantics/articleapplication/pdfapplication/pdfapplication/vnd.openxmlformats-officedocument.wordprocessingml.documenthttps://www.actamedicaportuguesa.com/revista/index.php/amp/article/view/5100oai:ojs.www.actamedicaportuguesa.com:article/5100Acta Médica Portuguesa; Vol. 27 No. 5 (2014): September-October; 581-586Acta Médica Portuguesa; Vol. 27 N.º 5 (2014): Setembro-Outubro; 581-5861646-07580870-399Xreponame:Repositório Científico de Acesso Aberto de Portugal (Repositórios Cientìficos)instname:Agência para a Sociedade do Conhecimento (UMIC) - FCT - Sociedade da Informaçãoinstacron:RCAAPporenghttps://www.actamedicaportuguesa.com/revista/index.php/amp/article/view/5100https://www.actamedicaportuguesa.com/revista/index.php/amp/article/view/5100/4062https://www.actamedicaportuguesa.com/revista/index.php/amp/article/view/5100/4182https://www.actamedicaportuguesa.com/revista/index.php/amp/article/view/5100/7069Félix-Morais, RicardoSargento-Freitas, JoãoSilva, FernandoCordeiro, GustavoNunes, CésarRibeiro, JoanaCordeiro, MiguelMoura, CristinaCunha, Luisinfo:eu-repo/semantics/openAccess2022-12-20T11:04:12Zoai:ojs.www.actamedicaportuguesa.com:article/5100Portal AgregadorONGhttps://www.rcaap.pt/oai/openaireopendoar:71602024-03-19T16:19:01.863366Repositório Científico de Acesso Aberto de Portugal (Repositórios Cientìficos) - Agência para a Sociedade do Conhecimento (UMIC) - FCT - Sociedade da Informaçãofalse |
dc.title.none.fl_str_mv |
Carotid Atherosclerosis and White Matter Hypodensities: a Controversial Relationship Aterosclerose Carotídea e Hipodensidades da Substância Branca: uma Relação Controversa |
title |
Carotid Atherosclerosis and White Matter Hypodensities: a Controversial Relationship |
spellingShingle |
Carotid Atherosclerosis and White Matter Hypodensities: a Controversial Relationship Félix-Morais, Ricardo |
title_short |
Carotid Atherosclerosis and White Matter Hypodensities: a Controversial Relationship |
title_full |
Carotid Atherosclerosis and White Matter Hypodensities: a Controversial Relationship |
title_fullStr |
Carotid Atherosclerosis and White Matter Hypodensities: a Controversial Relationship |
title_full_unstemmed |
Carotid Atherosclerosis and White Matter Hypodensities: a Controversial Relationship |
title_sort |
Carotid Atherosclerosis and White Matter Hypodensities: a Controversial Relationship |
author |
Félix-Morais, Ricardo |
author_facet |
Félix-Morais, Ricardo Sargento-Freitas, João Silva, Fernando Cordeiro, Gustavo Nunes, César Ribeiro, Joana Cordeiro, Miguel Moura, Cristina Cunha, Luis |
author_role |
author |
author2 |
Sargento-Freitas, João Silva, Fernando Cordeiro, Gustavo Nunes, César Ribeiro, Joana Cordeiro, Miguel Moura, Cristina Cunha, Luis |
author2_role |
author author author author author author author author |
dc.contributor.author.fl_str_mv |
Félix-Morais, Ricardo Sargento-Freitas, João Silva, Fernando Cordeiro, Gustavo Nunes, César Ribeiro, Joana Cordeiro, Miguel Moura, Cristina Cunha, Luis |
description |
Introduction: White matter hypodensities of presumed vascular origin, are recognized as an important cause of morbidity with established clinical and cognitive consequences. Nonetheless, many doubts remain on its physiopathology. Our goal is to clarify the potential role of carotid atherosclerosis and other vascular risk factors in the development of white matter hypodensities of presumed vascular origin.Material and Methods: We included patients that underwent CT brain scan and neurosonologic evaluation within a one-month period. Full assessment of vascular risks factors was performed. We seek to find independent associations between white matter hypodensities of presumed vascular origin, carotid intima-media thickness and vascular risk factors.Results: 472 patients were included, mean age was 67.32 (SD: 14.75), 274 (58.1%) were male. The independent predictors of white matter hypodensities of presumed vascular origin were age (OR: 1.067, 95% IC: 1.049 – 1.086, p < 0.001) and hypertension (OR: 1.726, 95% IC: 1.097 – 2.715, p = 0.018). No association was found between IMT (OR: 2.613, 95% IC: 0.886 – 7.708, p = 0.082) or carotid artery stenosis (OR: 1.021, 95% IC: 0.785 – 1.328, p = 0.877) and white matter hypodensities of presumed vascular origin.Discussion: Only age and hypertension proved to have an independent association with white matter hypodensities of presumed vascular origin. Carotid atherosclerosis, evaluated by IMT and the degree of carotid artery stenosis, showed no association with white matter hypodensities of presumed vascular origin. Since atherosclerosis is a systemic pathology, these results suggest that alternative mechanisms are responsible for the development of white matter hypodensities of presumed vascular origin.Conclusion: Age and hypertension seem to be the main factors in the development of white matter hypodensities of presumed vascular origin. No association was found between carotid atherosclerosis and white matter hypodensities of presumed vascular origin.Keywords: Brain; Carotid Artery Disease. |
publishDate |
2014 |
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2014-09-25 |
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info:eu-repo/semantics/publishedVersion |
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publishedVersion |
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https://www.actamedicaportuguesa.com/revista/index.php/amp/article/view/5100 oai:ojs.www.actamedicaportuguesa.com:article/5100 |
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https://www.actamedicaportuguesa.com/revista/index.php/amp/article/view/5100 |
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https://www.actamedicaportuguesa.com/revista/index.php/amp/article/view/5100 https://www.actamedicaportuguesa.com/revista/index.php/amp/article/view/5100/4062 https://www.actamedicaportuguesa.com/revista/index.php/amp/article/view/5100/4182 https://www.actamedicaportuguesa.com/revista/index.php/amp/article/view/5100/7069 |
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Ordem dos Médicos |
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Ordem dos Médicos |
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Acta Médica Portuguesa; Vol. 27 No. 5 (2014): September-October; 581-586 Acta Médica Portuguesa; Vol. 27 N.º 5 (2014): Setembro-Outubro; 581-586 1646-0758 0870-399X reponame:Repositório Científico de Acesso Aberto de Portugal (Repositórios Cientìficos) instname:Agência para a Sociedade do Conhecimento (UMIC) - FCT - Sociedade da Informação instacron:RCAAP |
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Repositório Científico de Acesso Aberto de Portugal (Repositórios Cientìficos) |
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