Hemodynamic state in the extra- and intracranial segments of the brachiocephalic arteries in patients with metabolic syndrome

Objective. To assess hemodynamic parameters in the extra- and intracranial segments of the brachiocephalic arteries (BCA) in patients with metabolic syndrome (MS) using duplex ultrasonography.

Materials and Methods. The study included 82 patients, of whom 62 had MS and 20 were practically healthy controls. All patients underwent duplex ultrasonography of the extra- and intracranial segments of the BCA with evaluation of qualitative and quantitative parameters: intima–media complex (CIM) in the bifurcation of the brachiocephalic trunk, in the common carotid arteries (CCA), and in the vertebral arteries (VA), as well as quantitative blood-flow parameters in the CCA, internal carotid arteries (ICA), VA, and middle cerebral arteries (MCA). All patients also underwent biochemical blood testing.

Results. Patients with MS demonstrated a statistically significant increase in peripheral resistance indices in the ICA (left ICA pulsatility index (PI), p = 0.05) and in the MCA/ICA resistance index ratio on the left side compared with controls (p = 0.026). No statistically significant differences in linear or volumetric blood-flow velocities were found in the studied  arteries. Significant correlations were found between quantitative blood-flow parameters and MS components based on Pearson’s linear correlation coefficients: the end-diastolic velocity in the left ICA correlated with low-density lipoproteins (LDL), total cholesterol (TC), atherogenic index, and both absolute and relative glucose dynamics in the oral glucose tolerance test; PI of the left ICA correlated with the CARO index; PI of the right VA correlated with LDL and TC; the MCA/ICA PI ratio on the left side correlated with LDL, high-density lipoproteins, TC, triglycerides, and the triglyceride–glucose index; as well as with fasting insulin, HOMA-IR index, and CARO index. Pearson correlation coefficients ranged from −0.41 to 0.24 at p < 0.05.

Conclusion. Comprehensive ultrasound evaluation of hemodynamics in the extra- and intracranial segments of the BCA in patients with MS allows detection of blood-flow alterations associated with structural remodeling of the vascular wall induced by the negative impact of multiple metabolic factors.

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