Carotid artery Disease Assessed by Color Doppler Flow Imaging: Comparison Between Diabetic and Non-Diabetic Patients
Abstract
Background: Carotid artery disease is most often seen in hypertensive patients and in patients with diabetes mellitus. More than 50% stenosis of extra cranial internal carotid arteries is linked with about 8–15% of ischemic strokes. The incidence of carotid artery stenosis (CAS) among diabetic patients is rising as compared to non-diabetic patients.
Methods: A cross-sectional study was performed on 120 patients, out of whom 60 were diabetic and 60 non-diabetics with clinically suspected carotid artery disease. The study was conducted at the university ultrasound clinic in Green Town by Doppler ultrasonography using the Toshiba XARIO XG, which features a linear probe of 5-7.5 MHz frequency. The data was analyzed with the help of SPSS version 25.0. Variables like age, gender, diabetes, and Intima-media thickness (IMT) were reported and the mean ± standard deviation of Pulsatility Index, Resistive Index, Peak Systolic Velocity, and End Diastolic Velocity were calculated with a significant p-value, which is less than 0.05. An independent t-test was applied to compare Doppler indices in diabetic and non-diabetic subjects.
Results: Data was collected from 120 patients. IMT of right and left carotid artery, PI and RI of right carotid were observed to be statistically significant in diabetic and non-diabetic.
Conclusions: This study concluded that there is a significant correlation found between carotid artery disease and diabetes. Through ultrasonography, the presence of plaque and stenosis was found in more diabetic patients than in non-diabetic patients.
Keywords: Ultrasonography; Carotid artery disease; Carotid artery stenosis; Carotid plaque; Vascular ultrasound; Diabetes
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Paul J, Shaw K, Dasgupta S, Ghosh MK. Measurement of intima media thickness of carotid artery by B-mode ultrasound in healthy people of India and Bangladesh, and relation of age and sex with carotid artery intima media thickness: An observational study. Journal of cardiovascular disease research, (2012);2:128-131.
Song P, Fang Z, Wang H, Cai Y, Rahimi K, Zhu Y, Fowkes FG, Fowkes FJ, Rudan I. Global and regional prevalence, burden, and risk factors for carotid atherosclerosis: a systematic review, meta-analysis, and modelling study. The Lancet Global Health, (2020);5:e721-e729.
Sobieszczyk P, Beckman J. Carotid artery disease. Circulation, (2006);7:e244-e247.
Rothwell PM. Carotid artery disease and the risk of ischemic stroke and coronary vascular events. Cerebrovascular Diseases, (2000);5:21-33.
Shaikh NA, Bhatty S, Irfan M, Khatri G, Vaswani AS, Jakhrani N. Frequency, characteristics and risk factors of carotid artery stenosis in ischaemic stroke patients at Civil Hospital Karachi. JPMA, (2010);1:8-12.
Bosevski M. Carotid artery disease in diabetic patients. Prilozi, (2014);1:53-63.
Ali FS, Bader N, Zuberi BF, Banu S. Frequency of silent carotid artery stenosis in diabetics and its associated factors: An analysis in tertiary care hospital. Pakistan Journal of Medical Sciences, (2020);6:1270.
De Weerd M, Greving JP, de Jong AW, Buskens E, Bots ML. Prevalence of asymptomatic carotid artery stenosis according to age and sex: systematic review and metaregression analysis. Stroke, (2009);4:1105-1113.
Hussain MA, Bin-Ayeed SA, Saeed OQ, Verma S, Al-Omran M. Impact of diabetes on carotid artery revascularization. Journal of vascular surgery, (2016);4:1099-1107.
Kim GH, Youn HJ. Is carotid artery ultrasound still useful method for evaluation of atherosclerosis?. Korean circulation journal, (2017);1:1-8.
Willeit P, Tschiderer L, Allara E, Reuber K, Seekircher L, Gao LU, Liao X, Lonn E, Gerstein HC, Yusuf S, Brouwers FP. Carotid intima-media thickness progression as surrogate marker for cardiovascular risk: meta-analysis of 119 clinical trials involving 100 667 patients. Circulation, (2020);7:621-642.
Parikh A, Daneman D. Is carotid ultrasound a useful tool in assessing cardiovascular disease in individuals with diabetes?. Diabetes technology & therapeutics, (2004);1:65-69.
De Angelis M, Scrucca L, Leandri M, Mincigrucci S, Bistoni S, Bovi M, Calabrese G, Pippi R, Parretti D, Grilli P, Colorio P. Prevalence of carotid stenosis in type 2 diabetic patients asymptomatic for cerebrovascular disease. Diabetes, nutrition & metabolism, (2003);3:1011-1016.
Göksan B, Erkol G, Bozluolcay M, Ince B. Diabetes as a determinant of high-grade carotid artery stenosis: evaluation of 1,058 cases by Doppler sonography. Journal of Stroke and Cerebrovascular Diseases, (2001);6:252-256.
Anand SS, Yusuf S, Vuksan V, Devanesen S, Teo KK, Montague PA, Kelemen L, Yi C, Lonn E, Gerstein H, Hegele RA. Differences in risk factors, atherosclerosis, and cardiovascular disease between ethnic groups in Canada: the Study of Health Assessment and Risk in Ethnic groups (SHARE). The lancet, (2000);9226:279-284.
Sacco RL, Kargman DE, Gu Q, Zamanillo MC. Race-ethnicity and determinants of intracranial atherosclerotic cerebral infarction: the Northern Manhattan Stroke Study. Stroke, (1995);1:14-20.
Wagenknecht LE, D’Agostino Jr R, Savage PJ, O’Leary DH, Saad MF, Haffner SM. Duration of diabetes and carotid wall thickness: the Insulin Resistance Atherosclerosis Study (IRAS). Stroke, (1997);5:999-1005.
Shah Ebrahim DM, Papacosta O, Whincup P, Wannamethee G, Walker M, Nicolaides AN, Dhanjil S, Griffin M, Belcaro G, Rumley A, Lowe GD. Carotid plaque, intima media thickness, cardiovascular risk factors, and prevalent cardiovascular disease in men and women. Arteriosclerosis, Thrombosis, and Vascular Biology, (2005);7:1482–1488.
Sutton-Tyrrell K, Alcorn HG, Wolfson Jr S, Kelsey SF, Kuller LH. Predictors of carotid stenosis in older adults with and without isolated systolic hypertension. Stroke, (1993);3:355-3561.
Crouse JR, Goldbourt U, Evans G, Pinsky J, Sharrett AR, Sorlie P, Riley W, Heiss G. Risk factors and segment-specific carotid arterial enlargement in the Atherosclerosis Risk in Communities (ARIC) cohort. Stroke, (1996);1:69-75.
Mast H, Thompson JL, Lin IF, Hofmeister C, Hartmann A, Marx P, Mohr JP, Sacco RL. Cigarette smoking as a determinant of high-grade carotid artery stenosis in Hispanic, black, and white patients with stroke or transient ischemic attack. Stroke, (1998);5:908-912.
Dempsey RJ, Moore RW. Amount of smoking independently predicts carotid artery atherosclerosis severity. Stroke, (1992);5:693-696.
Kawamoto R, Tomita H, Oka Y, Ohtsuka N. Association between risk factors and carotid enlargement. Internal medicine, (2006);8:503-509.
Baldassarre D, Amato M, Bondioli A, Sirtori CR, Tremoli E. Carotid artery intima-media thickness measured by ultrasonography in normal clinical practice correlates well with atherosclerosis risk factors. Stroke, (2000);10:2426-2430.
Su TC, Chien KL, Jeng JS, Chen MF, Hsu HC, Torng PL, Sung FC, Lee YT. Age-and gender- associated determinants of carotid intima-media thickness: a community-based study. Journal of atherosclerosis and thrombosis, (2012);9:872-880.
De Michele M, Panico S, Iannuzzi A, Celentano E, Ciardullo AV, Galasso R, Sacchetti L, Zarrilli F, Bond MG, Rubba P. Association of obesity and central fat distribution with carotid artery wall thickening in middle-aged women. Stroke, (2002);12:2923-2928.
Oughton JA, Rose S, Galloway G, Khoo SK, O'Neill S, Coulthard A. Carotid ultrasound pulsatility indices and cardiovascular risk in Australian women. Journal of medical imaging and radiation oncology,(2015);1:20-15.
Hitomi Y, Masaki N, Ishinoda Y, Kagami K, Yasuda R, Toya T, Namba T, Nagatomo Y, Takase B, Adachi T. Effectiveness of pulsatility index of carotid Doppler ultrasonography to predict cardiovascular events. Journal of Medical Ultrasonics, (2022);1:95-103.
Frauchiger B, Schmid HP, Roedel C, Moosmann P, Staub D. Comparison of carotid arterial resistive indices with intima-media thickness as sonographic markers of atherosclerosis. Stroke, (2001);4:836-841.
Bai CH, Chen JR, Chiu HC, Pan WH. Lower blood flow velocity, higher resistance index, and larger diameter of extracranial carotid arteries are associated with ischemic stroke independently of carotid atherosclerosis and cardiovascular risk factors. Journal of Clinical Ultrasound, (2007);6:322-330.
Chait A, Bornfeldt KE. Diabetes and atherosclerosis: is there a role for hyperglycemia?. Journal of lipid research, (2009);1:S335-S339.
DOI: http://dx.doi.org/10.62940/als.v10i1.1567
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