The Relationship between Left Ventricle Diastolic Dysfunction and Carotid Plaques in Elderly Patients with Ischemic Stroke

Yoon, Hyun Ju; Kang, Won Yu; Lee, Min Gu; Kim, Kye Hun; Kim, Ju Han; Ahn, Younggeun; Jeong, Myung Ho; Cho, Jung Gwan; Kang, Jung Chaee; Kim, Jun Tae; Park, Man Seok; Cho, Ki Hyun; Park, Jong Chun

Abstract

BACKGROUND: Atherosclerotic plaques in the carotid artery have been considered a potential source of cerebrovas- cular events. Carotid plaques are associated with an increased risk of ischemic stroke. We performed this study to evaluate the relationship between atherosclerotic carotid plaques and cardiac function measured by echocardiography in elderly patients with ischemic stroke.
METHODS
A total of 415 patients aged >60 yrs with acute ischemic stroke were divided into two groups according to the presence(groups I, n=195, 140 males) or absence(group II, n=220, 112 males) of carotid plaques. We evaluated the asso ciation of the presence of plaques with age, sex, potential vascular risk factors, other carotid images, and cardiac function by echocardiography.
RESULTS
Of the 415 patients, carotid plaques were found in 195 cases. Mean plaque size was 2.44+/-0.7mm on the right side and 2.32+/-0.75mm on the left. Plaques were located more frequently in the carotid bulb(68%) than in the common carotid artery(32%). 57% were calcified plaques and 72%, multiple plaques. Group I(with carotid plaques) had a significantly higher percentage of males(73.6%, p<0.001), hypertension(68.5%, p=0.043), diabetes(28.7%, p=0.029), and dyslipidemia(60.1%, p=0.008). In addition, group I had thicker carotid IMT than group II(Right: 0.86 vs. 0.70mm, p<0.001, Left: 0.90 vs. 0.73mm, p<0.001), lower common carotid artery end diastolic flow velocity(Right: 13.37 vs. 15.73m/s, p=0.002, Left: 14.46 vs.17.24m/s, p=0.004), and higher E/E'level(11.57 vs. 9.36, p=0.001). Old age, dyslipidemia, and diastolic dysfunction were independently associated with carotid plaques.
CONCLUSION
Our results indicated that old age, male gender, diabetes, hypertension, and dyslipidemia are more com- mon in patients with carotid plaques than in those without. Old age, male gender, dyslipidemia, and diastolic dysfunc- tion are independent risk factors of carotid plaques in elderly patients with ischemic stroke. We further concluded that though left ventricle systolic function is not associated with carotid plaques in elderly patients with ischemic stroke, left ventricle diastolic dysfunction is.