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Peripheral Arterial Disease II: Clinical Manifestations and Diagnostic Evaluation01:21

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Clinical manifestationsPeripheral Arterial Disease (PAD) manifests through a range of symptoms, from the characteristic intermittent claudication to atypical presentations and severe complications in advanced stages. Intermittent claudication, a hallmark symptom of PAD, presents as exercise-induced muscle pain that typically resolves within minutes of rest. This pain is reproducible and stems from inadequate blood flow, leading to the accumulation of lactic acid produced during anaerobic...
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Peripheral artery disease (PAD) predominantly results from atherosclerosis, which involves the accumulation of fatty deposits, or plaques, within the walls of arteries. This causes them to narrow and harden, significantly reducing blood flow. PAD predominantly affects the legs, particularly the arteries supplying the thighs and calves. In rare cases, it may involve other arteries, including those in the arms.Etiology of PAD:The principal cause of PAD is atherosclerosis, which results from fatty...
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DefinitionRenal angiography, also known as renal arteriography, is an imaging technique used to obtain a comprehensive view of blood flow and the vascular structure of blood vessels in the kidneys and surrounding areas.PurposeRenal angiography detects blood vessel abnormalities in the kidneys, such as aneurysms, stenosis, thrombosis, vascular tumors, and renal artery stenosis. It evaluates kidney function and guides interventional treatments like angioplasty or stent placement.Pre-Procedure...
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Bones are dynamic organs that require a rich supply of oxygen and nutrients. Around 5% to 10% of the cardiac output supplies blood to the bones. A typical long bone has three main sources: the nutrient artery, the metaphyseal and epiphyseal arteries, and the periosteal arteries.
Nutrient Artery
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The vascular phase, also known as vasospasm, is the initial stage of hemostasis, crucial for preventing excessive bleeding when a blood vessel is injured. After a vessel is cut, nerves in the damaged area trigger pain and other sensory impulses. Simultaneously, the smooth muscles in the vessel wall contract, resulting in a vascular spasm. This contraction reduces the vessel's diameter at the injury site, slowing or stopping blood loss through the vessel wall. Vascular spasms typically last...
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The human body's intricate network of arteries ensures that every organ system receives the necessary oxygen and nutrients for optimal function. The arterial network in the head and neck region is particularly complex, providing vital blood flow to the brain, eyes, and other critical structures. Prominent arteries in this region include the internal carotid arteries and the vertebral arteries.
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Exploring Cerebrovascular Function in Osteoarthritis: "Heads-up".

Baraa K Al-Khazraji1,2, Mark B Badrov1, Mason Kadem3

  • 1School of Kinesiology, Faculty of Health Sciences, Western University, London, Ontario, Canada.

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Summary

Osteoarthritis patients exhibit impaired cerebrovascular control and increased white matter lesions compared to healthy adults. These findings suggest pre-clinical cardiovascular risks in osteoarthritis, even without diagnosed disease.

Keywords:
Cerebrovascular controlcardiovascular disease risk factorsmagnetic resonance imagingosteoarthritistranscranial Doppler ultrasoundwhite matter lesions

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Area of Science:

  • Neurology
  • Cardiovascular Science
  • Rheumatology

Background:

  • Individuals with osteoarthritis (OA) face elevated risks for cardiovascular and cerebrovascular events.
  • Cerebrovascular control mechanisms in OA patients remain largely uncharacterized.
  • Understanding these mechanisms is crucial for identifying pre-clinical risks.

Purpose of the Study:

  • To quantify cerebrovascular control metrics in OA patients.
  • To compare these measures against healthy control adults (CTL).
  • To investigate anatomical and functional changes related to cerebrovascular reactivity in OA.

Main Methods:

  • Utilized 3T magnetic resonance imaging and transcranial Doppler.
  • Assessed global cerebrovascular reactivity index under hypercapnia.
  • Evaluated middle cerebral artery hemodynamic responses and autoregulation via a sit-to-stand task.
  • Measured white matter lesion volume and performed brief cognitive assessments.

Main Results:

  • OA patients demonstrated significantly lower global cerebrovascular reactivity index responses to hypercapnia compared to CTL.
  • Autoregulatory responses were impaired in OA patients.
  • OA patients exhibited greater white matter lesion volumes than CTL.
  • These differences remained significant after adjusting for cardiovascular risk factors.

Conclusions:

  • Patients with osteoarthritis, even without diagnosed cardiovascular disease, show pre-clinical impairments in peripheral and cerebrovascular control.
  • OA is associated with reduced cerebrovascular reactivity and increased white matter lesions.
  • These findings highlight potential underlying cerebrovascular dysfunction in OA patients.