Abstract
The relationship between epicardial fat thickness and coronary atherosclerosis is well known, but the value of the increased epicardial fat thickness in cerebrovascular diseases is still unclear.
Purpose
The aim of this study was to determine the relationship between common carotid artery intima–media thickness (CCA-IMT), the resistance index (RI) in the vertebral and carotid arteries and epicardial fat thickness (EFT) in patients with ischemic stroke.
Methods
98 patients with ischemic stroke (31 females and 67 males, mean age was 68.2 ± 12.1 years) were studied. All patients had arterial hypertension (AH). Most of them (96.9%) had grade 3 hypertension according to ESH/ESC Guidelines for the management of arterial hypertension, 2018. Forty-two (43.1%) patients had coronary artery disease and 35 (35.4%) - atrial fibrillation (AF). The exclusion criteria was the presence of chronic obstructive pulmonary disease or other diseases associated with pulmonary hypertension. Patients were categorized according to National Institutes of Health Stroke Scale (NIHSS) severity in mild NIHSS (≤8) - 54 (55.1%) patients, moderate NIHSS (9–15) - 23 (23.5%) patients, and severe stroke NIHSS (≥16) - 21 (21.4%) patients. Median NIHSS score was 11.2 ± 1.7. All patients underwent a transthoracic echocardiography and a carotid ultrasound examination.
Results
The common carotid artery intima–media thickness correlated with EFT (r =0.78, p < 0.001), the body mass index (r = 0.7, p < 0.001) and systolic blood pressure (r = 0.25, p = 0.045). The resistance index in the vertebral and carotid arteries correlated only with EFT (r = 0.7, p < 0.001 and r = 0.78, p < 0.001, respectively) and body mass index (r = 0.58, p < 0.001 and r = 0.68, p < 0.001, respectively).
A multiple regression analysis in which the CCA-IMT was a dependent variable and age, body mass index, systolic blood pressure, blood cholesterol level and epicardial fat thickness were independent variables, showed that CCA-IMT was independently correlated with blood cholesterol level (β=0.714, р<0.001) and EFT (β =0.255, р=0.002) in patients with ischemic stroke.
Conclusions
The common carotid artery intima–media thickness and parameters of the arterial stiffness of the extracranial vessels of the head are associated with the epicardial fat thickness and blood cholesterol level in patients with ischemic stroke. The common carotid artery intima–media thickness does not depend on age, gender, body mass index, systolic and diastolic blood pressure in patients with ischemic stroke.
Correlation between epicardial fat thickness with intima–media thickness and ankle–brachial index in patients with metabolic syndrome