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Transcranial Doppler indices of intracranial arteries in LDL . 180 mg/dL versus , 180 mg/dL groups (mean ± standard deviation)
Source publication
Hypercholesterolemia is one of the major modifiable risk factors for atherosclerosis of the coronary and carotid arteries. Although transcranial Doppler (TCD) studies of the cerebral arteries are indicative of decreased cerebral blood flow velocities in patients with hypercholesterolemia, the number of these studies has been limited. The aim of thi...
Contexts in source publication
Context 1
... find out whether higher levels of LDL alter the hemody- namics of the cerebral arteries, individuals with LDL levels of less and more than 180 mg/dL were compared ( Table 3). The mean blood flow velocity and resistance index of the internal carotid arteries in those with LDL . ...
Context 2
... mean blood flow velocity and resistance index of the internal carotid arteries in those with LDL . 180 mg/dL was signifi- cantly lower than that in individuals with LDL , 180 mg/dL (P , 0.05, Table 3). In addition, individuals with high- density lipoprotein (HDL) ,35 mg/dL were compared regarding TCD indices in both groups. ...
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The aim of the present study was to locate the ophthalmic artery by using the edge of the internal carotid artery (ICA) as the reference depth to perform a reliable non-invasive intracranial pressure measurement via a multi-depth transcranial Doppler device and to then determine the positions and angles of an ultr...
Citations
... Normal resistivity and pulsatility indices have been reported in the dolichoectatic arteries including VBD (33) which suggest normal peripheral resistance [34] and arterial compliance [35] in these arteries which can explain the lack of significant difference between patients with BAD and control groups regarding PI and RI in our study. On other hand, Mehdi F et al [36] in their study of the effect of hypercholesterolemia on Doppler parameters of intracranial arteries found that MBV, PI and RI of the intracranial arteries were not significantly different between the hypercholesterolemia and normal control groups which disagrees with our result. ...
Basilar artery dolichoectasia (BAD) is a disorder characterized by dilatation, elongation and tortuosity of the basilar artery. Transcranial Doppler ultrasound (TCD) is a useful tool that can detect blood flow in intracranial vessels including basilar artery (BA). Few studies have been conducted on blood flow changes in BAD. This study was conducted to evaluate the Doppler parameters in dolichoectatic BA and to assess if there is any difference in TCD findings between stroke and non-stroke BAD patients. A case-control study was conducted on 35 patients diagnosed with BAD (26 male, 9 female) and 35 age- and gender-matched control group (without BAD) at the Middle Euphrates Neuroscience Center, Al-Sader Medical City, Al-Najaf, Iraq. Dolichoectasia was diagnosed on non-enhanced brain CT scan using established imaging criteria according to Dan Deng et al criteria. Doppler flow for control and stroke cases was recorded. The parameters measured on TCD were peak systolic velocity (PSV), end diastolic velocity (EDV) mean blood velocity (MBV), pulsatility index (PI) and resistive index (RI). After logistic regression for adjustment for the significant confounders, there was statistically significant difference in Doppler parameters between both groups including decrease in each of PSV, EDV and MBV while both PI and RI weren’t statistically significant. Among BAD patients, there was statistically significant difference in all TCD parameters between stroke and non-stroke patients (PSV EDV, MBV, PI and RI). BAD was associated with a decrease in flow velocities as measured by TCD. Furthermore, among BAD patients, those with stroke had lower values for all Doppler parameters than non-stroke patients.
... Jeong et al. (2018) found that PI was significantly higher in patients with dyslipidemia (total cholesterol level >220 mg/dL or low-density lipoprotein cholesterol level >160 mg/dL) (p = 0.003) (15). However, Farhoudi et al found that resistence indeks rather than PI was significantly higher in patients with higher levels of LDL (180 mg/dL) (16). Our findings support that LDL level is associated with PI in the way of higher LDL level contribute in higher PI. ...
... Other than blood glucose and LDL level, PI of cerebral arteries also found to be related with age, hypertention, obesity, and angiopathy (11,(15)(16)(17)(18)(19). All of these findings suggest that TCD may be a valuable assessment in reassuring people with such risk factors to evaluate cerebral small vessel disease. ...
Introduction: Diabetes mellitus and dyslipidemia is the most common risk factors for stroke and are associated with atherosclerosis, which promote the incidence of stroke. The pulsatility index (PI) by transcranial color-coded duplex ultrasonography (TCCD) evaluates the vascular resistance of the distal of cerebral artery and can predict the cerebrovascular disease like stroke. The aim of the study is to correlate blood glucose and LDL level with PI of cerebral arteries evaluated by TCCD. Methods: The cross sectional study design was performed in 48 patients from January-December 2018 who performed TCCD and were tested for blood glucose and LDL level. Saphiro-Wilk test was performed to analyze the normality of the data then Spearman's rank correlation test was used to evaluate the correlation of the variables. Results: There were significant correlation of blood glucose and LDL level with PI of cerebral arteries (all p < 0.05). Conclusion: Blood glucose and LDL level are correlated with the PI of cerebral arteries.
... 10 Furthermore, cholesterol level was found to have a correlation with mean blood flow velocity (BFV) and S1 velocity. 9,11 It was suggested that patients with greater common carotid artery (CCA) plaque and intimal-medial thickness had a high velocity ratio and increased prevalence of coronary artery disease. 12 Despite the acknowledgment that VF is associated with some haemodynamic functions, including BP and arterial PWV, the extent to which VF accumulation has an influence on BFV in CCA is not well described. ...
Introduction:
The aim of this study was to evaluate the impact of different visceral fat (VF) and blood pressure (BP) levels on changes in blood flow velocity (BFV) among non-obese subjects, using a cross-sectional study approach.
Methods:
A total of 110 putatively healthy and non-obese subjects were divided into three groups according to their level of VF and BP. Common carotid artery BFV was measured using a developed portable Doppler ultrasound measurement system.
Results:
The most pronounced peak systolic velocity (S1) was lower (p < 0.05) in the hypertensive group and the peak diastolic velocity (D) was significantly lower in the pre-hypertensive group than in the normotensive group. There were differences in velocity reflection and resistive indices between the hypertensive and other two BP groups. The higher VF group had significantly lower S1 and D velocities and resistive and vascular elasticity indices. By contrast, the velocity reflection index was larger in the higher VF group.
Conclusions:
We confirmed that there were significant differences in the BFV among non-obese subjects who differed in level of VF and BP. This study confirms that a putatively increasing VF and BP level is associated with the development of hypertension.
... This gave a required sample size of 20 subjects per group with a total of 60 subjects. A 10 cm/s difference in middle cerebral artery blood flow velocity was deemed to be clinically significant according to research previously carried out [6,[15][16][17][18][19]. Data analysis was performed using SPSS 15.0 (Statistical Package for the Social Sciences, Chicago, IL, USA). ...
... In another study, a TCD study which was performed to assess the hemodynamic status of cerebral arteries in adult patients with hypercholesterolemia revealed that low-density lipoproteins >160 mg/dL did not seem to have a detrimental effect on the hemodynamic status of the intracranial arteries. However, those with higher levels of low-density lipoproteins (>180 mg/dL) and lower levels of high-density lipoproteins (<35 mg/dL) showed significantly lower mean blood flow velocities in the internal carotid arteries [16]. In the current study, serum triglyceride and total cholesterol levels were significantly higher than controls (p < 0.05) but no significant relationship was found between TCD velocities and blood lipid profiles. ...
Background
Obesity affects all major organ systems and leads to increased morbidity and mortality. Whole blood viscosity is an important independent regulator of cerebral blood flow. The aim of the present study was to evaluate the effect of whole blood viscosity on cerebral artery blood flow velocities using transcranial Doppler ultrasound in pediatric patients with obesity compared to healthy controls and analyze the effect of whole blood viscosity and blood pressure status to the cerebral artery blood flow velocities.
Methods
Sixty patients with obesity diagnosed according to their body mass index (BMI) percentiles aged 13–18 years old were prospectively enrolled. They were grouped as hypertensive or normotensive according to their ambulatory blood pressure monitoring. Whole blood viscosity and middle cerebral artery velocities by transcranial Doppler ultrasound were studied and compared to 20 healthy same aged controls.
Results
Whole blood viscosity values in hypertensive (0.0619±0.0077 poise) and normotensive (0.0607±0.0071 poise) groups were higher than controls (0.0616±0.0064 poise), with no significance. Middle cerebral artery blood flow velocities were higher in the obese hypertensive (73.9±15.0 cm/s) and obese normotensive groups (75.2±13.5 cm/s) than controls (66.4±11.5 cm/s), but with no statistical significance.
Conclusions
Physiological changes in blood viscosity and changes in blood pressure did not seem to have any direct effect on cerebral blood flow velocities, the reason might be that the cerebral circulation is capable of adaptively modulating itself to changes to maintain a uniform cerebral blood flow.
... Stroke is one of the leading causes of death in the world and the main cause of disability in adults. 1,2 Acute ischemic stroke (AIS) accounts for 88% of stroke events. 3 Despite the success of reperfusion therapies in patients with AIS, these therapies are only available to a minority of patients-and even patients who receive reperfusion therapy are at risk of neuronal death because of secondary neurodegenerative mechanisms. ...
Introduction
Psychological factors have always been considered for their role on risk taking behavior such as substance abuse, risky driving and smoking. The aim of this study was to determine the association between smoking behavior and potential personality patterns among high school students in Tabriz, Iran.
Methods
Through a multistage sampling in a cross-sectional study, 1000 students were enrolled to represent the final grade high school student population of Tabriz, Iran in 2013. The personality patterns along with smoking status and some background information were collected through standard questionnaires along with Millon Clinical Multiaxial Inventory-III (MCMI-III). Fourteen personality patterns and ten clinical syndromes. ANOVA and Kruskal Wallis tests were used to compare numeric scales among the study participants, with respect to their smoking status. Stata version 13 statistical software package was used to analyze the data. Multivariate logistic regression was used to predict likelihood of smoking by personality status.
Results
Two logistic models were developed in both of whom male sex was identified as a determinant of regular smoking (1st model) and ever-smoking (2nd model). Depressive personality increased the likelihood of being a regular smoker by 2.8 times (OR=2.8, 95% CI: 1.3–6.1). The second personality disorder included in the model was sadistic personality with an odds ratio of 7.9 (96% CI: 1.2–53%). Histrionic personality increased the likelihood of experiencing smoking by 2.2 times (OR=2.2, 95% CI: 1.6–3.1) followed by borderline personality (OR=2.8, 95% CI: 0.97–8.1).
Conclusion
Histrionic and depressive personalities could be considered as strong associates of smoking, followed by borderline and sadistic personalities. A causal relationship couldn’t be assumed unless well controlled longitudinal studies reached the same findings using psychiatric interviews.
... Nevertheless, increasing evidence suggests that also asymptomatic intracranial arteries stenosis is associated with traditional cardiovascular risk factors and that this finding is an independent predictor of vascular mortality [19][20][21][22][23] so the importance of screening asymptomatic intracranial stenosis has not to be omitted, according to these recent studies (no definitive results has been reached in this area, that is why more attention has to be paid to this point). ...
Doppler ultrasound scanning is the first line investigation for quantifying the internal carotid artery stenosis. Nevertheless, the lack of internationally accepted ultrasound criteria for describing the degree of stenosis has contributed to the different and confusing measurements ranges. The use of two different angiographic methods, the North American Symptomatic Carotid Endoarterectomy Study and the European Carotid Surgery Trial was probably the major initial source of confusion in deriving valid and reliable duplex ultrasound criteria worldwide. The consensus proposed in 2003 by the Society of Radiologists in Ultrasound has been a great attempt to create a conformity document, establishing grey scale and Doppler criteria in considering the different degrees of stenosis. According to this attempt, in 2010, the multi-parametric Deutsche Gesellschaft für Ultraschall in der Medizin ultrasound criteria have been proposed with a precise differentiation between main and additional criteria and depicted a different peak systolic velocity (PSV) threshold. In 2012, these criteria have been implemented, focusing on the multi-parametric approach, re-defining the PSV values and clearly introducing the concept of PSV average. Despite these attempts, a wide range of practice patterns still exists, with consistent disparities in patients’ care. This paper collects these previous experiences and summarizes their strengths and weaknesses, to give a contribution in the carotid artery stenosis grading standardization using ultrasonic methods. Carotid ultrasound as the only diagnostic tool for the selection of patients for carotid surgery or stenting will be possible only with internationally accepted criteria.
... Farhoudi et al. reported formation of atheroma plaque is caused by inflammation of blood vessel where small LDL particles able to enter the intima media. Deposited LDL leads to narrowing of vessel lumen [25]. This increases blood vessel intima media thickness and vascular resistance [26]. ...
... Stroke is one of the leading causes of death in the world and the main cause of disability in adults. 1,2 Acute ischemic stroke (AIS) accounts for 88% of stroke events. 3 Despite the success of reperfusion therapies in patients with AIS, these therapies are only available to a minority of patients-and even patients who receive reperfusion therapy are at risk of neuronal death because of secondary neurodegenerative mechanisms. ...
Acute ischemic stroke is a major cerebrovascular disease with potential morbidity and mortality. Despite the availability of thrombolytic therapy in some centers, risk factor modification and rehabilitation therapy are the mainstays of stroke management. There is supporting evidence that Ginkgo biloba may afford neuroprotection and improve the outcomes of patients with acute ischemic stroke.
In a double-blind, placebo-controlled, randomized controlled trial, we assessed the efficacy of G biloba on functional outcome in patients with acute stroke. The National Institutes of Heath Stroke Scale (NIHSS) was used to measure functional outcome. A total of 102 patients with acute ischemic stroke were studied. All patients received either G biloba or placebo tablets for 4 months. This trial was registered to the Iranian Registry of Clinical Trials (www.irct.ir; trial IRCT138804212150N1).
There were 52 patients who received G biloba and 50 patients who were in the placebo group. Age, sex distribution, previous medical condition, and laboratory data did not have any significant difference between the 2 groups (P > .05). The mean difference of 4-month follow-up NIHSS scores and NIHSS scores at admission was 4.7 ± 2.7 and 4.1 ± 3.0 in the G biloba and placebo groups, respectively (P > .05). The primary outcome-a 50% reduction in the 4-month follow-up NIHSS score compared to the baseline NIHSS score-was reached in 17 patients (58.6%) and 5 patients (18.5%) in the G biloba and placebo groups, respectively (P < .05). The risk ratio and number needed to treat were 3.16 (confidence interval 1.35-7.39) and 2.50 (confidence interval 1.58-5.90), respectively. In addition, multivariate regression adjusted for age and sex revealed a significant NIHSS decline in the G biloba group compared to the placebo group (P < .05).
Our data suggest that G biloba may have protective effects in ischemic stroke. Therefore, the administration of G biloba is recommended after acute ischemic stroke.
... Novel medical interventions require further attention from the side of health-care providers ( Azarfarin et al., 2013;Mortazavi et al., 2013;Naghipour et al., 2013;Javadzadeh et al., 2013;Khoei et al., 2011;Aslanabadi et al., 2010;Aslanabadi et al., 2011). Diagnostic approaches per se consume the main part of the finance supported by insurance companies ( Ayromlou et al., 2013;Bavil et al., 2011;Nemati et al., 2010;Farhoudi et al., 2011;Farhoudi et al., 2010;Totonchi et al., 2008;. Treatment health sector is considered as one of the main sectors in socioeconomic activities of any country, such that economically considerable financial resources allocate to this sector in order to support, maintain and improve the country people's health ( Whitehead et al., 2001). ...
Today, the way of supplying treatment service expenditures, though is considered as a serious challenge for governments of most of the world countries, is one of the main problems of most low or average-income families. In this research, determining the extent of direct and out of pocket payments of diabetic patients for receiving treatment and comparison of treatment expenditures of diabetes in all kinds of insurance have been considered. This research design is causal-comparative. Information needed in this research is collected by researcher-made questionnaire, content validity of which is confirmed by professions. Data analysis has been done by the statistical model of one way analysis of variance, follow-up test of Dancan and t-test. Among people with three kinds of insurances of Treatment Services, Social Support, and other insurances regarding general expense, native & non-native patient expenditures, direct and indirect ones, emergency and normal patients expenditures, the ratio of out of pocket payment and direct expense, there is significant difference. Also, there has been seen significant difference (p<0.01،F=19.37) in out of pocket payment ratio from direct expenditures and general ones (F=25.36, p<0.01) in three kinds of insurances being studied, such that out of pocket payment who is under the insurance of treatment services 59.55%, social supply 50.34% and other insurances 32%. Though improvements in the country's health and treatment indices, the health system has been faced with serious challenge in the way of supplying treatment care service expenditures and the insurance system has low efficacy in protecting families against health expenditures. Therefore it seems that attempts to integrate insurances and maximize service insurance coverage and their promise limits could be proper method in decreasing the ratio of out of pocket payment and protecting families against confronting with excess health expenditures and poorness resulted from that. [Hassan Nezhad N, Rasmiyya Sabir Qizi A. Reform in Insurance Payment in Iran. Life Sci J 2013;10(12s):39-46] (ISSN:1097-8135). http://www.lifesciencesite.com. 9
... Patients with previous deep vein thrombosis of the lower limbs presented with skin ulcers, variceal veins or leg edema were included in the present study. Examinations were performed using a HITACHI EUB-525 color Doppler ultrasonography with 5-7.5 MHz linear probe (Ghabili et al., 2009; Ardalan et al., 2009; Nemati et al., 2010; Ansarin et al., 2010; Farhoudi et al., 2011; Bavil et al., 2011; Bavil et al., 2012). All examinations were performed with the patient on supine and stand positions. ...
Chronic venous insufficiency of deep venous system in most cases is an acquired disorder which occurs following deep vein thrombosis, and can subsequently followed by skin changes and disability. Color Doppler sonography is the main diagnostic tool for chronic venous insufficiency, and also is a useful tool for identifying the distribution and extent of venous reflux. The aim of this study was to evaluate the prevalence and distribution of venous insufficiency in patients with post-thrombotic scar at lower extremity venous system. Fifty three limbs of 48 subjects were evaluated. Patients with previous deep vein thrombosis of the lower limbs presented with skin ulcers, variceal veins or leg edema were included in the present study. Venous Doppler scanning was commenced at external iliac vein (EIV) and moved to common femoral vein (CFV), saphenofemoral junction (SFJ), superficial femoral vein (SFV), greater saphenous vein (GSV), popliteal vein (POPV), saphenopopliteal junction (SPJ), lesser saphenous vein (LSV), calf veins (CV), and perforator veins (PV), respectively. The results showed that prevalence of thrombotic scar was more common in proximal deep veins of the limbs. Moreover, popliteal vein was the most common insufficient vein (58.5%). Perforator veins also had no thrombotic scar but they were insufficient in 3 patients (5.66%). This study also showed that severe stenosis or occlusion was most common in external iliac veins (12 patients). In conclusion, the chronic post-thrombotic scar was common at proximal veins. Moreover, deep vein insufficiency was more common than superficial system. In addition, POPV was found as the most common insufficient vein.
