scholarly journals The impact of vascular risk factors on the thickness and volume of the choroid in AMD patients

2021 ◽  
Vol 11 (1) ◽  
Author(s):  
Elżbieta Krytkowska ◽  
Aleksandra Grabowicz ◽  
Katarzyna Mozolewska-Piotrowska ◽  
Zofia Ulańczyk ◽  
Krzysztof Safranow ◽  
...  
Keyword(s):  
Risk Factors ◽  
Vascular Risk Factors ◽  
Age Related Macular Degeneration ◽  
Control Group ◽  
Vascular Risk ◽  
Average Volume ◽  
Central Ring ◽  
Age Related ◽  
The Impact ◽  
Wet Amd

AbstractDisturbances in choroidal microcirculation may lead to the onset and progression of age-related macular degeneration (AMD). We aimed to assess changes in the choroidal volume and thickness in the macular region in AMD eyes and to investigate whether coexisting vascular risk factors alter choroidal status. We enrolled 354 AMD patients (175 dry, 179 wet AMD) and 121 healthy controls. All participants underwent a complete ophthalmologic examination and assessment of choroidal thickness and volume. A multivariate analysis adjusted for age, sex, and smoking status revealed that wet AMD was an independent factor associated with higher average thickness of the central ring area (ATC) and average volume of the central ring area (AVC) and lower choroidal vascularity index (CVI) compared to controls (β =  + 0.18, p = 0.0007, β =  + 0.18, p = 0.0008, respectively) and to dry AMD (β =  + 0.17, p = 0.00003 for both ATC and AVC and β =  − 0.30 p < 0.0001 for CVI). ATC, AVC and average volume (AV) were lower in AMD patients with hypertension and ischaemic heart disease (IHD). The duration of hypertension was inversely correlated with ATC, AVC and AV (Rs =  − 0.13, p < 0.05; Rs =  − 0.12; p < 0.05, Rs =  − 0.12; p < 0.05, respectively) while IHD duration negatively correlated with AV (Rs =  − 0.15, p < 0.05). No such associations were observed in the control group. Our findings show that the choroidal vascular system in eyes with AMD is much more susceptible to damage in the presence than in the absence of systemic vascular disease.

scholarly journals Inner Ear Disorders in the Elderly with Carotid Artery Disease Requiring Revascularization: Prevalence, Characteristics, and Association

2020 ◽  
Vol 2 (3) ◽  
Author(s):  
RAZAN AL FAKIR
Keyword(s):  
Risk Factors ◽  
Carotid Artery ◽  
Inner Ear ◽  
Carotid Artery Disease ◽  
Vascular Risk Factors ◽  
Control Group ◽  
Study Group ◽  
Vascular Risk ◽  
Age Related ◽  
Artery Disease

Background: Aging is almost assocaited with inner ear disorders (InEarDs) by means of age-related hearing impairment (ARHI) or vertigo-and-dizziness as well as the carotid artery disease requiring revascularization (CAD-R).Objective: The present study aimed to study the prevalence and characteristics of InEarDs in older adults diagnosed with CAD-R. The other aim was to determine if InEarDs in CAD-R patients is age-related or might be explained by a concomitant CAD-R.Method: A retrospective, case-control study was conducted at the Mayo Clinic, Florida. The study cohort includes 919 patients who had CAD-R. The control group consisted of 244 age- and gender-matched patients presenting with cardiac or peripheral artery disease. The InEarDs were assessed based on the diagnosis upon presentation to the Audiology Clinic and follow-up.Results: Of the 919, 348 had ARHI that includes significant peripheral signs and central symptoms (24.9%), vertigo-and-dizziness events that are recurrent and persistent with normal objective vestibular testing (12.9%), or a combination of both (11.0%). These percentages were significantly higher in the study group relative to the control group. After adjustment for the vascular risk factors, the study group had significantly higher odds of ARHI (OR= 1.94; 95% CI: 1.09-3.44; P<0.05),Conclusion: CAD-R patients had significantly higher InEarDs than the control group. CAD-R is more likely to be associated with ARHI rather than the vertigo-and-dizziness even after adjusting for the vascular risk factors.

Abstract TP407: Effects of Remote Ischemic Conditioning on Cerebral Small Vessel Disease Outcomes

Stroke ◽  
2017 ◽  
Vol 48 (suppl_1) ◽  
Author(s):  
Yuan Wang ◽  
Haiqing Song ◽  
Kai Dong ◽  
Ran Meng ◽  
Shuying Wang ◽  
...  
Keyword(s):  
Risk Factors ◽  
Flow Velocity ◽  
Small Vessel Disease ◽  
Cerebral Small Vessel Disease ◽  
Vascular Risk Factors ◽  
Control Group ◽  
Vascular Risk ◽  
Remote Ischemic Conditioning ◽  
Ischemic Conditioning ◽  
Vessel Disease

Objective: To evaluate the preliminary efficacy of remote ischemic conditioning (RIC) on patients with cerebral small vessel disease (SVD). Methods: Thirty patients diagnosed with symptomatic SVD within 30 days of onset were enrolled in this prospectively randomized controlled study for 1 year. All patients received routine medical treatment including treating vascular risk factors according to the guideline. Patients in the experimental group (n=14) were administered 5 cycles consisting of ischemia followed by reperfusion for 5 minutes on bilateral upper limbs twice daily for 1 year. Those in the control group (n=16) underwent sham ischemia-reperfusion cycles. Primary outcome was the change of cognitive function measured by mini-mental state examination (MMSE) and montreal cognitive assessment scale (MoCA), and secondary outcomes were changes of plasma biomarkers, cerebral hemodynamic parameters measured by vascular ultrasound and brain lesions measured by MRI FLAIR both at baseline and at the end of 1 year visit. Results: Compared with patients in the control group, patients in the RIC group had higher flow velocity (FV), and lower pulsatility index (PI), but without statistical difference. Patients in the RIC group had improvement in visuospatial and executive abilities (3.86±1.03 vs. 4.43±0.85, p=0.026), reduced plasma triglyceride (1.60±0.74 vs. 1.25±0.38, p=0.019), low density lipoprotein (2.89±0.81 vs. 2.26±0.67, p=0.003) and homocysteine (15.66±10.11 vs. 13.66±9.80 p=0.017). Similarly in the RIC group, the diastolic flow velocity (DFV) of middle cerebral artery (MCA) (right: 33.93±7.67 vs. 36.93±6.12, p=0.032; left: 33.93±7.67 vs. 36.93± 6.12, p=0.032) and the mean flow velocity (MFV) of left MCA (35.00±5.04 vs. 39.50±5.59, p=0.003) increased, and the PI of MCA (right: 1.11±0.19 vs. 1.02±0.14 p=0.030; left: 1.10±0.22 vs. 0.99±0.14, p=0.037) decreased. Conclusion: RIC appears to be potentially effective for improving cognition, enhancing cerebral perfusion, and modifying vascular risk factors in SVD patients. Further studies focusing on long-term neurological outcomes and potential mechanisms underlying RIC on SVD patients are needed.

Application of 25-National Eye Institute Visual Function Questionnaire in ophthalmological patients

2020 ◽  
Vol 2 (3) ◽  
pp. 1-8
Author(s):  
Luciano Mesquite Simmo ◽  
Carissa Fouad Ibrahim ◽  
Senice Alvarenga Rodrigues Silva ◽  
Thai Nunes Andrade ◽  
Doora Faleiros Leite ◽  
...  
Keyword(s):  
Visual Function ◽  
Peripheral Vision ◽  
Statistical Significance ◽  
Eye Diseases ◽  
Age Related Macular Degeneration ◽  
Control Group ◽  
Ischemic Optic Neuropathy ◽  
Age Related ◽  
Visual Function Questionnaire ◽  
The Impact

Objective: To compare the vision-targeted health related quality of life (HRQOL) between neuro-ophthalmological patients and other eye diseases by the National Eye Institute 25-Item Visual Function Questionnaire. Methods: Cross sectional study with a control group and patients with the following pathologies: primary open-angle glaucoma (POAG), diabetic retinopathy (DR), age-related macular degeneration (ARMD), non-arteritic ischemic optic neuropathy (NAION), intracranial hypertension (IH), optic neuritis (ON), ptosis and cataract. Results: All comparisons of the subscales scores among the control group and the patient groups were statistically significant (p<0.05) except for “ocular pain” (p=0.160), “social functioning” (p=0.052) and “peripheral vision” (p=0.112). The control group had the best scores across all dimensions of the NEI VFQ-25. Interestingly, the ARMD and cataract groups presented the best and worst total scores of NEI VFQ-25, respectively. The lowest subscales scores were found in the cataract, in the NAION/ON, and in the POAG groups. Finally, the comparison between the NAION/ON/IH patients and the other eye diseases did not show statistical significance in any subscale. Conclusion: The NEI VFQ-25 showed the impact of various eye conditions in vision-targeted HRQOL, and no difference was measured between neuro-ophthalmological patients and other eye diseases

P1-319: The impact of beta-amyloid deposition and vascular risk factors on cortical thickness and cognition

2013 ◽  
Vol 9 ◽  
pp. P274-P275
Author(s):  
Sylvia Villeneuve ◽  
Bruce Reed ◽  
Cindee Madison ◽  
Miranka Wirth ◽  
Stephen Kriger ◽  
...  
Keyword(s):  
Risk Factors ◽  
Cortical Thickness ◽  
Beta Amyloid ◽  
Amyloid Deposition ◽  
Vascular Risk Factors ◽  
Vascular Risk ◽  
The Impact

scholarly journals The Impact of Vascular Risk Factors on Post-stroke Cognitive Impairment: The Nor-COAST Study

2021 ◽  
Vol 12 ◽  
Author(s):  
Stina Aam ◽  
Mari Nordbø Gynnild ◽  
Ragnhild Munthe-Kaas ◽  
Ingvild Saltvedt ◽  
Stian Lydersen ◽  
...  
Keyword(s):  
Risk Factors ◽  
Atrial Fibrillation ◽  
Coronary Heart Disease ◽  
Cognitive Impairment ◽  
Vascular Risk Factors ◽  
Vascular Risk ◽  
Z Score ◽  
Cognitive Domains ◽  
Post Stroke ◽  
The Impact

Introduction: Post-stroke cognitive impairment (PSCI) is common, but evidence on the impact of vascular risk factors is lacking. We explored the association between pre-stroke vascular risk factors and PSCI and studied the course of PSCI.Materials and Methods: Vascular risk factors were collected at baseline in stroke survivors (n = 635). Cognitive assessments of attention, executive function, memory, language, and the Montreal Cognitive Assessment (MoCA) were performed at 3 and/or 18 months post-stroke. Stroke severity was assessed with the National Institutes of Health Stroke Scale (NIHSS). PSCI was measured with global z; MoCA z-score; and z-score of the four assessed cognitive domains. Mixed-effect linear regression was applied with global z, MoCA z-score, and z-scores of the cognitive domains as dependent variables. Independent variables were the vascular risk factors (hypertension, hypercholesterolemia, smoking, diabetes mellitus, atrial fibrillation, coronary heart disease, previous stroke), time, and the interaction between these. The analyses were adjusted for age, education, and sex. There were between 5 and 25% missing data for the variables for PSCI.Results: Mean age was 71.6 years (SD 11.7); 42% were females; and the mean NIHSS score at admittance was 3.8 (SD 4.8). Regardless of vascular risk factors, global z, MoCA, and all the assessed cognitive domains were impaired at 3 and 18 months, with MoCA being the most severely impaired. Atrial fibrillation (AF) was associated with poorer language at 18 months and coronary heart disease (CHD) with poorer MoCA at 18 months (LR = 12.80, p = 0.002, and LR = 8.32, p = 0.004, respectively). Previous stroke was associated with poorer global z and attention at 3 and 18 months (LR = 15.46, p &lt; 0.001, and LR = 16.20, p &lt; 0.001). In patients without AF, attention improved from 3 to 18 months, and in patients without CHD, executive function improved from 3 to 18 months (LR = 10.42, p &lt; 0.001, and LR = 9.33, p = 0.009, respectively).Discussion: Our findings indicate that a focal stroke lesion might be related to pathophysiological processes leading to global cognitive impairment. The poorer prognosis of PSCI in patients with vascular risk factors emphasizes the need for further research on complex vascular risk factor interventions to prevent PSCI.

scholarly journals Association between excessive premature atrial complexes and cryptogenic stroke: results of a case–control study

BMJ Open ◽  
2019 ◽  
Vol 9 (7) ◽  
pp. e029164 ◽  
Author(s):  
Jithin K Sajeev ◽  
Anoop N Koshy ◽  
Helen Dewey ◽  
Jonathan M Kalman ◽  
Kevin Rajakariar ◽  
...  
Keyword(s):  
Risk Factors ◽  
Ischaemic Stroke ◽  
Case Control Study ◽  
Cryptogenic Stroke ◽  
Case Control ◽  
Vascular Risk Factors ◽  
Control Group ◽  
Prior History ◽  
Vascular Risk ◽  
Control Study

ObjectiveRecent anticoagulation trials in all-comer cryptogenic stroke patients have yielded equivocal results, reinvigorating the focus on identifying reproducible markers of an atrial myopathy. We investigated the role of excessive premature atrial complexes (PACs) in ischaemic stroke, including cryptogenic stroke and its association with vascular risk factors.Methods and resultsA case–control study was conducted utilising a multicentre institutional stroke database to compare 461 patients with an ischaemic stroke or transient ischaemic attack (TIA) with a control group consisting of age matched patients without prior history of ischaemic stroke/TIA. All patients underwent 24-hour Holter monitoring during the study period and atrial fibrillation was excluded. An excessive PAC burden, defined as ≥200 PACs/24 hours, was present in 25.6% and 14.7% (p<0.01), of stroke/TIA and control patients, respectively. On multivariate regression, excessive PACs (OR 1.97; 95% CI 1.29 to 3.02; p<0.01), smoking (OR 1.58; 95% CI 1.06 to 2.36; p<0.05) and hypertension (OR 1.53; 95% CI 1.07 to 2.17; p<0.05) were independently associated with ischaemic stroke/TIA. Excessive PACs remained the strongest independent risk factor for the cryptogenic stroke subtype (OR 1.95; 95% CI 1.16 to 3.28; p<0.05). Vascular risk factors that promote atrial remodelling, increasing age (≥75 years, OR 3.64; 95% CI 2.08 to 6.36; p<0.01) and hypertension (OR 1.54; 95% CI 1.01 to 2.34; p<0.05) were independently associated with excessive PACs.ConclusionsExcessive PACs are independently associated with cryptogenic stroke and may be a reproducible marker of atrial myopathy. Prospective studies assessing their utility in guiding stroke prevention strategies may be warranted.

Abstract TP166: The Topmost Modifiable Risk Factors for Stroke Among People of African Ancestry

Stroke ◽  
2017 ◽  
Vol 48 (suppl_1) ◽  
Author(s):  
Mayowa O Owolabi ◽  
Fred S Sarfo ◽  
Onoja Akpa ◽  
Mulugeta Gebregziabher ◽  
Rufus Akinyemi ◽  
...  
Keyword(s):  
Risk Factors ◽  
African Ancestry ◽  
Vascular Risk Factors ◽  
Systematic Evaluation ◽  
Modifiable Risk Factors ◽  
Large Artery ◽  
Vascular Risk ◽  
Geographical Variations ◽  
Catchment Areas ◽  
The Impact

Background: Regional and geographical variations exist in stroke burden and risk factor distribution. The unique and dominant risk factors for stroke among people of African ancestry where the burden of stroke is escalating, are poorly understood. Such information is crucial in prioritizing tailor-made interventions to tackle the menace of stroke in developing countries. Purpose: We aimed to identify and quantify the contributions of the topmost modifiable risk factors for stroke occurrence in people of African ancestry within the context of the Stroke Investigative Research and Educational Network (SIREN), the largest study of stroke in Africa. Methods: The SIREN study is an ongoing, multicenter, case-control study involving several sites in Nigeria and Ghana. Cases included adults aged >18 years with first clinical stroke within 8 days of current symptom onset with CT scan confirmation. Controls were stroke-free adults, mostly from the communities in the catchment areas of the SIREN hospitals where cases were recruited. A systematic evaluation of traditional vascular risk factors as well as lifestyle and behavioral factors were assessed for cases and controls. Results: 1,638 cases and 1,653 controls with mean ages of 58.52 and 57.76 years respectively were recruited. Ischemic and hemorrhagic stroke types constituted 62.4% and 36.1% of stroke respectively. Among ischemic stroke subjects, 45.7%, 36.3%, 13.6%, 1.0% and 3.4% had small-vessel, large-artery atherosclerosis, cardio-embolic, others and unknown subtypes according to the TOAST classification. Leading vascular risk factors identified among stroke subjects compared with controls were hypertension- 79.3% vs 34.6%, p<0.001; Dyslipidemia 20.8% vs 6.6%, p<0.001; Diabetes mellitus- 24.4% vs 12.8% and history of cardiac diseases 15.4% vs 7.9%, p<0.001. Adjusted ORs (95% CI) for hypertension, dyslipidemia, cardiac disease and diabetes among stroke subjects compared with controls were 6.43 (5.84-7.54), 2.08 (1.61-2.69), 1.48 (1.15-1.91) and 1.29 (1.05-1.60) respectively. Conclusion: Implementation of interventions towards mitigating the impact of vascular risk factors at the population level would be essential in curtailing the growing burden of stroke in Africans.

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