Left ventricular geometry as a predictor of carotid artery stenosis severity in patients undergoing carotid artery
Bilge Duran Karaduman1, Hüseyin Ayhan1, Telat Keleş2
1Faculty of Medicine, Department of Cardiology, Atılım University, Medicana International Ankara Hospital, Ankara, Turkey.
Insights
Left ventricular (LV) geometry provides prognostic information for carotid artery stenosis severity. Abnormal LV geometry independently predicts stenosis severity in patients undergoing carotid artery stenting (CAS).
Area of Science:
- Cardiology
- Neurology
- Vascular Medicine
Background:
- Cerebrovascular diseases are a leading cause of death globally.
- Carotid artery stenosis contributes significantly to stroke incidence.
- The prognostic role of left ventricular (LV) geometry in carotid artery stenosis is not well-established.
Purpose of the Study:
- To investigate the prognostic value of LV geometry in predicting carotid artery stenosis severity.
- To assess the relationship between LV geometry and outcomes in patients undergoing carotid artery stenting (CAS).
Main Methods:
- Retrospective evaluation of 98 patients who underwent CAS between 2012 and 2016.
- Analysis of accessible echocardiographic data to assess LV geometry.
- Correlation of LV geometry with carotid artery stenosis severity and procedural complications.
Main Results:
- Left ventricular normal geometry was observed in 37.7% of patients.
- Concentric hypertrophy was associated with statistically significantly higher stenosis severity (p:0.012).
- Left ventricular mass index (LVMi) and Doppler velocity significantly correlated with stenosis severity (p < .001).
Conclusions:
- Echocardiographic assessment of LV geometry offers prognostic insights into carotid artery stenosis.
- Abnormal LV geometry is an independent predictor of carotid artery stenosis severity in patients undergoing CAS.
Background And Aim:
Cerebrovascular diseases are the second most common cause of death worldwide. Moderate and severe carotid artery stenosis causes nearly 10% of all strokes. LV geometry is a familiar prognostic and diagnostic factor in several populations; yet, data on its role in carotid artery stenosis are unknown. In our study, we investigated the prognostic value of LV geometry in predicting carotid artery stenosis severity in patients undergoing carotid artery stenting.
Methods:
Patients who underwent carotid artery stenting between January 2012 and January 2016 at our tertiary care center were evaluated retrospectively. Two hundred fifty-five patients who underwent carotid artery stenting were included in the study. Accessible echocardiographic documentation of ninety-eight patients was accessed and evaluated.
Results:
LV normal geometry was detected in 37 (37.7%) of the 98 carotid artery stenting (CAS) patients, concentric hypertrophy in 13 (13.2%), eccentric hypertrophy in 9 (9.1%), and concentric remodeling in 39 (39.7%). By a majority, distal filter was used in normal geometry and eccentric hypertrophy groups (82.9% vs 100%, P: .017). Considering the relationship between carotid artery stenosis severity and LV geometry, we determined that the stenosis severity was statistically significantly higher in the concentric hypertrophy group (p:0.012). However, although no complications were detected in the concentric hypertrophy group, it did not reach statistical significance between the groups (P: .058). LVMi and as expected, Doppler velocity showed a significant correlation with stenosis severity (r = .23 vs .54; P: .021, <.001, respectively).
Conclusion:
Echocardiographic evaluation of LV geometry provided prognostic information in the development of carotid artery stenosis. Abnormal LV geometry is an independent predictor in detecting the severity of carotid artery stenosis undergoing carotid artery stenting.
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