LINKING ULTRASOUND ASSESSMENT OF EXTRACRANIAL CEREBRAL CIRCULATION TO BIOLOGICAL PROFILE OF INFLAMMATION AND COAGULATION AT HYPERTENSIVE PATIENTS WITH OR WITHOUT DIABETES MELLITUS

Objective: The study’s objective was to estimate how the ultrasound parameters of the carotid arteries correlate with the proinflammatory and prothrombotic imbalances in hypertensive patients (pts) with or without diabetes mellitus (DM). Design and method: 40 hypertensive pts (mean age=63.5±9.6 years, 52.5% males)-group 1 and 40 hypertensive pts with DM, matched for age and sex (mean age=65.4±10.5 years, 55% males)-group 2. Vascular ultrasound parameters performed in carotid arteries were: thickness of intimal-media layer (IMT) in common carotid arteries (CCA), peak systolic velocity (PSV) in internal carotid arteries (ICA), end-diastolic velocity (EDV) in ICA, resistance index (RI) in ICA, peak systolic velocity ratio (PSVR) in ICA and CCA. The inflammatory profile was estimated by serum measurement of C reactive protein (CRP) and fibrinogen (F). The prothrombotic profile was determined by serum measurement of von Willebrand factor (vWf), antithrombin III (AT III), and plasminogen activator inhibitor type 1 (PAI-1). Results: In group 1, a higher level of CRP was significantly associated with higher EDV in ICA (29.8±3.5 cm/s vs 15.6±2.4 cm/s, p=0.03) and with greater IMT in CCA (1±0.2 mm vs 0.5±0.3 mm, p=0.01). In group 2, a higher level of CRP was significantly associated with greater RI in ICA (0.76±0.11 vs 0.58±0.13, p=0.02). In the same group, pts with greater level of vWf have, in a significantly higher proportion, greater RI in ICA (0.78±0.12 vs 0.59±0.13, p=0.03) and higher PSVR in ICA and CCA (2.64±0.13 vs 1.21±0.16, p=0.04). In the same group, a greater proportion of PAI-1 is significantly associated with higher EDV in ICA (28.5±2.8 cm/s vs 16.4±2.6 cm/s, p=0.03) and with greater PSVR in ICA and CCA (2.71±0.21 vs 1.12±0.18, p=0.01). Conclusions: Greater IMT in CCA and a higher level of EDV in ICA seem to reflect a proinflammatory status in hypertensive pts. Higher RI in ICA appears to express both proinflammatory status and prothrombotic imbalance in hypertensive pts with DM. Moreover, greater PSVR in ICA and CCA and higher level of EDV in ICA seem to indicate a prothrombotic status in hypertensive pts with DM.