Abstract:
BACKGROUND AND PURPOSE:A pulsatility index (PI) represents vascular resistance distal to an examined artery. The purpose of the present study was to evaluate an association between plasma total homocysteine (tHcy) and PIs of the cerebral arteries in patients with ischemic stroke. METHODS:Consecutive patients with ischemic stroke referred to a neurovascular ultrasound laboratory were evaluated from March 2007 to February 2008. PI was defined as (peak systolic velocity-end-diastolic velocity)/mean flow velocity as recommended. Transcranial Doppler was examined in both middle cerebral arteries and vertebral arteries, and basilar arteries. All patients with ischemic stroke were subdivided according to the presence of proximal internal carotid arterial steno-occlusion (ICS). RESULTS:The numbers of patients enrolled for the present analysis as ischemic stroke without and with ICS were 272 and 92, respectively. PIs measured in the cerebral arteries did not show a significant difference in the two groups, in spite of the fact that mean flow velocities of both basilar arteries and vertebral arteries were significantly elevated in the patients with ICS. Plasma tHcy was found to be independently associated with graded increases of PIs in all cerebral arteries in the patients without ICS, even adjusted for the potential confounders. However, there was no association between tHcy and PI in the patients with ICS. CONCLUSION:Plasma tHcy was directly associated with increased cerebral arterial resistance. But in clinical situations when the cerebral arterial hemodynamics were altered as in the patients with ICS, the effect of tHcy on arterial remodeling could be obscured.
journal_name
Strokejournal_title
Strokeauthors
Lim MH,Cho YI,Jeong SKdoi
10.1161/STROKEAHA.109.558403subject
Has Abstractpub_date
2009-10-01 00:00:00pages
3216-20issue
10eissn
0039-2499issn
1524-4628pii
STROKEAHA.109.558403journal_volume
40pub_type
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