Lower Extremity Artery Disease and Cognitive Impairment

Abstract Background The association between cerebrovascular disease and cognitive impairment is well known, but the impact of lower extremity arterial disease (LEAD) on neuropsychological performance is less established. Objectives The aim of this study was to investigate the influence of LEAD on cognitive impairment. Materials and Methods A total of 20 patients with LEAD, classified by Fountain’s stage IIB, qualified for revascularization surgery has been included in this prospective study. Neuropsychological assessments have been done using MoCA and CANTAB test. Fifteen patients qualified for hernia surgery, without peripheral artery disease served as a control group. Linear regression model has been applied to assess the connection between LEAD and cognitive impairment. Results Differences between the study groups reach significance in both MoCA and CANTAB test. In MoCA test, patients with LEAD had lower levels of performance in attention (p = 0.0254), visuospatial/executive (p = 0.0343) and delayed recall (p = 0.0032). The mean MoCA score was below 26 points. In CANTAB test, patients with LEAD performed worse in visual memory and learning. After adjusted for common cerebrovascular risk factors, LEAD was significantly correlated with cognitive impairment defined as MoCA score < 26 points. Conclusions Lower extremity artery disease is associated with cognitive impairment independently of cerebrovascular risk factors.

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The Association of Lipoprotein(a), Apolipoprotein(a) Phenotypes and Autoantibodies to Lipoprotein(a) With Lower Extremity Artery Disease

Kardiologiia ◽

10.18087/cardio.2018.12.10176 ◽

2018 ◽

Vol 58 (12) ◽

pp. 45-51 ◽

Cited By ~ 1

Author(s):

N. A. Tmoyan ◽

O. I. Afanasieva ◽

E. A. Klesareva ◽

M. I. Afanasieva ◽

O. A. Razova ◽

...

Keyword(s):

Risk Factors ◽

Lower Extremity ◽

Main Group ◽

Lower Limbs ◽

Control Group ◽

Lipoprotein A ◽

National Medical ◽

Apolipoprotein A ◽

Artery Disease ◽

Lower Extremity Artery Disease

Aim. Lipoprotein(a) [Lp(a)] and low molecular weight (LMW) apolipoprotein(a) [apo(a)] phenotype are risk factors of сoronary heart disease and stroke. Data about the role of Lp(a) and phenotypes apo(a) in the development of lower extremity artery disease (LEAD) is scarce. The aim of our study was to assess the association of Lp(a), apo(a) phenotypes and autoantibodies to apolipoprotein B100 (apoB100) lipoproteins with LEAD.Materials and methods. The study included 622 patients (386 male and 236 female, average age 61±12 years), examined in the Department of Atherosclerosis of National Medical Research Center of Cardiology. Patients were divided into 2 groups: the main group included 284 patients with LEAD, 338 patients without significant atherosclerosis of coronary, carotid and lower limbs arteries formed the control group. LEAD was diagnosed as atherosclerotic lesions with at least one stenosis of low limb artery ≥50 % and anklebrachial index ≤0.9. The concentration of Lp(a), lipids was measured in blood serum of all the patients, level of autoantibodies to apoB100 lipoproteins was measured in 247 patients, and apo(a) phenotypes were determined in 389 patients.Results.Patients with LEAD were older, were more frequently male, and had a greater prevalence of risk factors including hypertension, type 2 diabetes, smoking than the control group patients (p<0.001 in all the cases). The level of Lp(a) was significantly higher in the main group compared to control group: 35 [14; 67] mg / dl vs. 14 [5; 32] mg / dl, p<0,001. ROC analysis demonstrated that the level of Lp(a) ≥26 mg / dl was associated with LEAD (sensitivity 61 %, specificity 70 %). The prevalence of Lp(a) ≥26 mg / dl and LMW apo(a) phenotype were higher in the main group in comparison with the control group: 61 % vs. 30 % and 48 % vs. 26 % respectively (p<0.001 in the both cases). The odds ratio of LEAD in the presence of Lp(a) ≥26 mg / dl was 3.7 (95 % confidence interval (CI), 2.6–5.1, p<0.001) and in the presence of LMW apo(a) phenotype was 2.6 (95 % CI, 1.7–4.0, p<0.001). In logistic regression analysis adjusted for age, sex, hypertension, smoking, diabetes, both Lp(a) and LMW apo(a) phenotype were independent predictors of LEAD when included separately. The level of IgM autoantibodies to Lp(a) was significantly higher in the control group compared to the patients with LEAD (p=0.01). Concentration of IgG autoantobodies to Lp(a) and LDL in the plasma did not differ essentially in the both groups.Conclusion.The level of Lp(a) ≥26 mg / dl and LMW apo(a) phenotype are independent predictors of LEAD, whereas the contribution of autoantobodies to Lp(a) in LEAD development is controversial.

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Differences in Brain Volume, Hippocampal Volume, Cerebrovascular Risk Factors, and Apolipoprotein E4 Among Mild Cognitive Impairment Subtypes

Archives of Neurology ◽

10.1001/archneurol.2009.252 ◽

2009 ◽

Vol 66 (11) ◽

Cited By ~ 45

Author(s):

Jing He ◽

Sarah Farias ◽

Oliver Martinez ◽

Bruce Reed ◽

Dan Mungas ◽

...

Keyword(s):

Risk Factors ◽

Cognitive Impairment ◽

Mild Cognitive Impairment ◽

Brain Volume ◽

Hippocampal Volume ◽

Apolipoprotein E4 ◽

Cerebrovascular Risk Factors ◽

Cerebrovascular Risk

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The impact of cerebrovascular risk factors on postoperative memory decline in patients with left temporal lobe epilepsy

Epilepsy & Behavior ◽

10.1016/j.yebeh.2019.106558 ◽

2020 ◽

Vol 102 ◽

pp. 106558

Author(s):

Anny Reyes ◽

Sanam J. Lalani ◽

Erik Kaestner ◽

Kiera Hooper ◽

Austin Chen ◽

...

Keyword(s):

Risk Factors ◽

Temporal Lobe Epilepsy ◽

Temporal Lobe ◽

Left Temporal Lobe ◽

Memory Decline ◽

Cerebrovascular Risk Factors ◽

Cerebrovascular Risk ◽

The Impact

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Cortical Ischemic Lesion Burden Measured by DIR Is Related to Carotid Artery Disease Severity

Cerebrovascular Diseases ◽

10.1159/000369292 ◽

2014 ◽

Vol 39 (1) ◽

pp. 23-30 ◽

Cited By ~ 7

Author(s):

Doriana Landi ◽

Paola Maggio ◽

Domenico Lupoi ◽

Paola Palazzo ◽

Claudia Altamura ◽

...

Keyword(s):

Risk Factors ◽

Carotid Artery ◽

Disease Severity ◽

Carotid Artery Disease ◽

Carotid Disease ◽

Ischemic Lesion ◽

Cerebrovascular Risk ◽

Artery Disease ◽

The Impact

Background: Over time, exposure to cerebrovascular risk factors and carotid artery disease may cause multiple asymptomatic brain cortical and subcortical microinfarcts, which are commonly found at brain autopsy. So far, lack of convenient neuroimaging tools limited the investigation of grey matter ischemic damage in vivo. We applied the Double Inversion Recovery (DIR) sequence to explore the impact of carotid artery disease on intracortical ischemic lesion load in vivo, taking into account the impact of demographic characteristics and vascular risk factors. Methods: DIR was acquired in 62 patients with common cerebrovascular risk factors stratified in three groups according to carotid artery disease severity. Intracortical lesions scored on DIR (DIRlns) were classified by vascular territory, lobe and hemisphere. White matter hyperintensities (WMHs) volume was also quantified on Fluid Attenuated Inversion Recovery sequence (FLAIR). Results: Among demographic characteristics and cerebrovascular risk variables explored, General Linear Model indicated that age and carotid artery disease were significantly associated to DIRlns. After correcting for age, DIRlns load was found to be significantly dependent on carotid artery stenosis severity (F(2, 58) = 5.56, p = 0.006). A linear positive correlation between DIRlns and WMHs was found after correcting for age (p = 0.003). Conclusions: Carotid disease severity is associated with DIRlns accrual. Microembolism and impaired cerebral hemodynamics may act as physiopathological mechanisms underlying cortical ischemic damage. The role of other factors, such as small vessel disease and the possible interaction with carotid disease, remains to be further explored.

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230 Prevalence and risk factors of lower extremity artery disease in subjects without traditional modifiable cardiovascular risk factors. The multi-ethnic study of atherosclerosis

Archives of Cardiovascular Diseases Supplements ◽

10.1016/s1878-6480(11)70232-4 ◽

2011 ◽

Vol 3 (1) ◽

pp. 75

Author(s):

Victor Aboyans ◽

Robyn L. Mcclelland ◽

Matthew A. Allison ◽

Mary M. Mcdermott ◽

Roger S. Blumenthal ◽

...

Keyword(s):

Risk Factors ◽

Cardiovascular Risk ◽

Lower Extremity ◽

Cardiovascular Risk Factors ◽

Ethnic Study ◽

Artery Disease ◽

Lower Extremity Artery Disease

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The Impact of Sociodemographic, Environmental, and Behavioral Factors, and Cerebrovascular Risk Factors as Potential Predictors of the Mattis Dementia Rating Scale

The Journals of Gerontology Series A ◽

10.1093/gerona/52a.2.m111 ◽

1997 ◽

Vol 52A (2) ◽

pp. M111-M116 ◽

Cited By ~ 4

Author(s):

W. Freidl ◽

R. Schmidt ◽

W.-J. Stronegger ◽

B. Reinhart

Keyword(s):

Risk Factors ◽

Rating Scale ◽

Behavioral Factors ◽

Mattis Dementia Rating Scale ◽

Cerebrovascular Risk Factors ◽

Cerebrovascular Risk ◽

Dementia Rating Scale ◽

The Impact

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Abnormal levels of brain metabolites may mediate cognitive impairment in stroke-free patients with cerebrovascular risk factors

Age and Ageing ◽

10.1093/ageing/afu027 ◽

2014 ◽

Vol 43 (5) ◽

pp. 681-686 ◽

Cited By ~ 8

Author(s):

D. Sun ◽

J. Zhang ◽

Y. Fan ◽

X. Liu ◽

Y. Gao ◽

...

Keyword(s):

Risk Factors ◽

Cognitive Impairment ◽

Brain Metabolites ◽

Cerebrovascular Risk Factors ◽

Cerebrovascular Risk

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Cerebrovascular Risk Factors in Migraine with Prolonged Aura and Without Aura

Cephalalgia ◽

10.1046/j.1468-2982.1991.1106257.x ◽

1991 ◽

Vol 11 (6) ◽

pp. 257-261 ◽

Cited By ~ 2

Author(s):

Volker Pfaffenrath ◽

Ingrid Kommissari ◽

Walter Pöllmann ◽

Holger Kaube ◽

Michael Rath

Keyword(s):

Risk Factors ◽

Platelet Aggregation ◽

Mitral Valve ◽

Mitral Valve Prolapse ◽

Migraine Without Aura ◽

Control Group ◽

Cardiac Arrythmias ◽

Cerebrovascular Risk Factors ◽

Cerebrovascular Risk

The role of cerebrovascular risk factors such as mitral valve prolapse, platelet aggregation, platelet activation and cardiac arrythmias in migraine was investigated in a total of 44 migraineurs (32 migraineurs without aura and 12 with prolonged aura) and 32 controls. Comparing the total of migraineurs and the two subgroups with controls, mitral valve prolapse, a raised thromboxane B2 level, at least one platelet aggregation dysfunction or an abnormality in 24-h ECG was statistically seen no more often than in the control group. Neither did combinations of the variables occur more frequently. Altogether, this study showed no increased coincidence of migraine with prolonged aura and migraine without aura with the above parameters. The absence of cardiac and haematological abnormalities in migraine with prolonged aura focuses attention on the control of the cortical microcirculation.

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Effect of Hierarchical Nursing Management in Patients with Hypertension Complicated with Cardiovascular and Cerebrovascular Risk Factors

Computational and Mathematical Methods in Medicine ◽

10.1155/2021/1246566 ◽

2021 ◽

Vol 2021 ◽

pp. 1-8

Author(s):

Lu Dai

Keyword(s):

Risk Factors ◽

Blood Pressure ◽

Compliance Rate ◽

Nursing Intervention ◽

Control Group ◽

Nursing Management ◽

Rehospitalization Rate ◽

Cerebrovascular Complications ◽

Cerebrovascular Risk Factors ◽

Cerebrovascular Risk

Hierarchical management is an essential component of nurse post management and an unavoidable tendency in nursing education. According to their existing condition, various hospitals around the country have actively tested the hierarchical usage and management model of clinical nurses, with some success. The application impact of hierarchical nursing care in patients with hypertension complicated by cardiovascular and cerebrovascular risk factors is the focus of this research. In a hospital, 300 patients with hypertension complicated by cardiovascular and cerebrovascular risk factors were chosen. All patients were split into two groups using the coin-throwing random method: the observation group received hierarchical nurse management and the control group received regular nursing management, with 150 cases in each group. The two groups’ blood pressure, blood lipids, blood glucose, poor habits, rehospitalization rate, and cardiovascular and cerebrovascular problems were also examined. At the same time, the patients’ poor mood and quality of life were assessed before and after the intervention. In the control group followed up for 1 year, the blood pressure compliance rate was 44.88%, the blood lipid compliance rate was 28.65%, the blood glucose compliance rate was 45.00%, the smokers with bad lifestyle habits were 26.57%, the overweight and obese were 23.5%, the high sodium was 31.67%, the rehospitalization rate was 15.48%, and the incidence of cardiovascular and cerebrovascular complications was 43.00%. The observation group’s blood pressure, blood lipids, and blood sugar compliance rates rose substantially ( P = 0.05 ) as compared to the control group. The occurrence of poor luck living habits, the rate of rehospitalization, and the incidence of cardiovascular and cerebrovascular complications were significantly reduced ( P < 0.05 ). Before nursing intervention, there was no significant difference in the bad mood scores SAS, SDS, and quality of life between the two groups of patients ( P > 0.05 ); after nursing intervention, compared with the control group, the observation group’s bad mood scores were significantly reduced, physical factors, psychological factors, and total scores all increased significantly, and the difference was statistically significant ( P < 0.05 ).

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