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Association Between Systemic Inflammation, Carotid Arteriosclerosis, and Autonomic Dysfunction

Sven Rupprecht1,2, S Finn3, D Hoyer3

  • 1Hans Berger Department of Neurology, Jena University Hospital, Erlanger Allee 101, 07740, Jena, Germany. Sven.Rupprecht@med.uni-jena.de.

Translational Stroke Research
|May 17, 2019
PubMed

Insights

Systemic inflammation is linked to carotid arteriosclerosis, not generalized disease. This connection is driven by reduced vagal tone, suggesting autonomic dysfunction plays a key role in inflammation associated with carotid artery disease.

Area of Science:

  • Cardiovascular Medicine
  • Neuroscience
  • Immunology

Background:

  • Systemic inflammation is a known risk factor for arteriosclerotic disease progression and poorer stroke outcomes.
  • The precise mechanisms linking systemic inflammation to carotid arteriosclerotic disease remain incompletely understood.

Purpose of the Study:

  • To investigate the hypothesis that systemic inflammation in carotid arteriosclerotic disease is mediated by impaired carotid baroreceptor and chemoreceptor function.
  • To differentiate the role of localized carotid arteriosclerosis versus generalized arteriosclerotic processes in driving systemic inflammation.

Main Methods:

  • 105 patients with asymptomatic carotid stenosis underwent assessment of heart rate variability (HRV), serum inflammatory markers, and demographic/lifestyle factors.
  • Multivariate linear regression analyses were employed to identify independent determinants of carotid stenosis severity, autonomic function, and inflammation.

Main Results:

  • Carotid stenosis severity, age, and arterial hypertension were independently associated with increased carotid stenosis severity.
  • Carotid stenosis severity, but not generalized arteriosclerosis or other comorbidities, was linked to reduced vagal tone (HRV HF band power).
  • Systemic inflammation was directly associated with reduced vagal tone, independent of generalized arteriosclerosis, comorbidities, or lifestyle factors.

Conclusions:

  • Systemic inflammation in the context of arteriosclerotic disease is primarily associated with carotid arteriosclerosis, rather than generalized arteriosclerotic burden.
  • The findings suggest that carotid arteriosclerosis-induced autonomic dysfunction, specifically reduced vagal tone, is a key mediator in the pathogenesis of systemic inflammation.

Keywords:
AtherosclerosisAutonomic nervous systemCarotid stenosisInflammation

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