Background: Carotid atherosclerosis and endothelial dysfunction are early structural and functional markers of systemic atherosclerosis that can be assessed non-invasively by high resolution duplex. Objective: To assess the extent and severity of extra-cranial carotid atherosclerosis and endothelial function in patients with and without atherosclerotic stroke by using high resolution duplex sonography. Methods: This study included 30 patients with stroke, 30 with atherosclerotic risk factors and 30 controls. They were subjected to clinical assessment, SMART scoring, laboratory workup, ECG, CT brain, duplex scanning of the carotid, vertebral and brachial artery. Results: CCA IMT, CCA RI and ICA RI increased while FMD% and significantly decreased in patient groups compared to control. (p<0.01). Males, patients with positive family history, smokers, obese patients, hypertensives, diabetics and patients with +ve carotid plaques had significantly higher carotid IMT and resistivity indices and lower FMD% and FMD/NTG (p<0.05). The SMRT score and plaque score were significantly higher in patients in comparison to controls (p<0.01). Risk factors severity was significantly correlated with the Duplex parameters. Conclusion: Carotid atherosclerosis and ED are early functional and structural markers of systemic atherosclerosis Carotid IMT and brachial artery FMD% as markers of atherosclerosis are affected more with increasing number of risk factors. (Egypt J Neurol Psychiat Neurosurg. 2010; 47(1): 11-20)
Key words: atherosclerosis, carotid duplex, endothelial dysfunction
Correspondence to Amany M. Rabah, Department of Neurology, Cairo University, Egypt.
Tel: +02 0122421045 E-mail: amanyrabah@hotmail.com