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A Murine Model of Stent Implantation in the Carotid Artery for the Study of Restenosis
Published on: May 14, 2013
Long-term effects of baroreflex function after stenting in patients with carotid artery stenosis
Chih-Cheng Huang1, Yi-Shan Wu, Tainsong Chen
1Institute of Biomedical Engineering, National Cheng Kung University, Tainan, Taiwan.
Insights
Carotid stenting patients show reduced baroreflex sensitivity, similar to those with severe carotid stenosis. This impairment likely stems from underlying conditions, not the procedure itself, with no lasting autonomic dysfunction observed post-stenting.
Area of Science:
- Cardiology
- Neurology
- Autonomic Neuroscience
Background:
- Baroreflex sensitivity is crucial for cardiovascular and cerebrovascular risk prognosis.
- Long-term baroreflex function outcomes after carotid stenting remain largely uncharacterized.
- Carotid stenosis poses significant risks, necessitating effective treatment strategies like stenting.
Purpose of the Study:
- To evaluate baroreflex sensitivity and autonomic function in patients post-carotid stenting.
- To compare autonomic function between stented patients, those with severe stenosis, and healthy controls.
- To determine if carotid stenting impacts long-term baroreflex sensitivity.
Main Methods:
- Non-invasive assessment of heart rate variability and cardiovascular autonomic function.
- Inclusion of 22 adult patients post-carotid stenting.
- Comparison with 22 healthy controls and 10 patients with severe carotid stenosis (risk controls).
Main Results:
- Patients undergoing carotid stenting and risk controls exhibited significantly reduced baroreflex sensitivity (Valsalva method) compared to normal controls.
- No significant difference in baroreflex sensitivity was found between the stenting and risk control groups.
- Carotid stenting patients showed decreased heart rate response to deep breathing and head-up tilt versus normal controls.
Conclusions:
- Reduced baroreceptor function in stented patients is likely attributable to underlying diseases, not the stenting procedure.
- Carotid stenting does not appear to cause short-term parasympathetic hyperactivity.
- The observed autonomic effects seem transient, suggesting potential for recovery or minimal long-term impact.
Abstract:
Baroreflex sensitivity is recognized for its prognostic relevance to cardio-vascular and cerebro-vascular risks. However, little is known about the long-term outcome of baroreflex function in patients with carotid stenosis undergoing carotid stenting. Heart rate variability and cardio-vascular autonomic function, including baroreflex sensitivity, were examined using non-invasive methods in 22 adult patients who underwent carotid stenting. They were compared with the normal control group with 22 sex- and age-matched normal volunteers and the risk control group with 10 adult patients with severe stenosis or even total occlusion of the carotid artery without stenting. The groups of patients with stenting and risk controls had significantly reduced valsalva ratio and baroreflex sensitivity measured by the valsalva method compared to normal controls. However, there was no significant difference between patients with stenting and risk controls. There was significant decrease in heart rate response to deep breathing and to head-up tilt in patients with carotid stenting compared to normal controls. Other parameters of cardio-vascular autonomic function showed no difference among the three groups. Reduced baroreceptor function in patients with carotid stenting may be due to underlying diseases rather than the stenting itself. There was no short-term parasympathetic hyperactivity after the stenting, suggesting that the effect is transient rather than permanent.
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