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Long-term effects of baroreflex function after stenting in patients with carotid artery stenosis

  • Chih-Cheng Huang
    Affiliations
    Institute of Biomedical Engineering, National Cheng Kung University, Tainan, Taiwan

    Department of Neurology, Chang Gung Memorial Hospital-Kaohsiung Medical Center, Chang Gung University College of Medicine, Kaohsiung, Taiwan
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  • Yi-Shan Wu
    Affiliations
    Department of Neurology, Chang Gung Memorial Hospital-Kaohsiung Medical Center, Chang Gung University College of Medicine, Kaohsiung, Taiwan
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  • Tainsong Chen
    Affiliations
    Institute of Biomedical Engineering, National Cheng Kung University, Tainan, Taiwan
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  • Wen-Neng Chang
    Affiliations
    Department of Neurology, Chang Gung Memorial Hospital-Kaohsiung Medical Center, Chang Gung University College of Medicine, Kaohsiung, Taiwan
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  • Yi-Chun Du
    Affiliations
    Institute of Biomedical Engineering, National Cheng Kung University, Tainan, Taiwan
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  • Chiung-Jen Wu
    Affiliations
    Division of Cardiology, Department of Internal Medicine, Chang Gung Memorial Hospital-Kaohsiung Medical Center, Chang Gung University College of Medicine, Kaohsiung, Taiwan
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  • Hon-Kan Yip
    Affiliations
    Division of Cardiology, Department of Internal Medicine, Chang Gung Memorial Hospital-Kaohsiung Medical Center, Chang Gung University College of Medicine, Kaohsiung, Taiwan
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  • Nai-Wen Tsai
    Affiliations
    Department of Neurology, Chang Gung Memorial Hospital-Kaohsiung Medical Center, Chang Gung University College of Medicine, Kaohsiung, Taiwan
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  • Teng-Yeow Tan
    Affiliations
    Department of Neurology, Chang Gung Memorial Hospital-Kaohsiung Medical Center, Chang Gung University College of Medicine, Kaohsiung, Taiwan
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  • Yao-Chung Chuang
    Affiliations
    Department of Neurology, Chang Gung Memorial Hospital-Kaohsiung Medical Center, Chang Gung University College of Medicine, Kaohsiung, Taiwan
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  • Hung-Chen Wang
    Affiliations
    Department of Neurosurgery, Chang Gung Memorial Hospital-Kaohsiung Medical Center, Chang Gung University College of Medicine, Kaohsiung, Taiwan
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  • Cheng-Hsien Lu
    Correspondence
    Corresponding author. Department of Neurology, Chang Gung Memorial Hospital, #123, Ta Pei Road, Niao Sung Hsiang, Kaohsiung Hsien, Taiwan. Tel.: +886 7 731 7123x2283; fax: +886 7 790 2684.
    Affiliations
    Department of Neurology, Chang Gung Memorial Hospital-Kaohsiung Medical Center, Chang Gung University College of Medicine, Kaohsiung, Taiwan

    Department of Biological Science, National Sun Yat-Sen University, Kaohsiung, Taiwan
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      Abstract

      Baroreflex sensitivity is recognized for its prognostic relevance to cardio-vascular and cerebro-vascular risks. However, little is known about the long-term outcome of baroreflex function in patients with carotid stenosis undergoing carotid stenting. Heart rate variability and cardio-vascular autonomic function, including baroreflex sensitivity, were examined using non-invasive methods in 22 adult patients who underwent carotid stenting. They were compared with the normal control group with 22 sex- and age-matched normal volunteers and the risk control group with 10 adult patients with severe stenosis or even total occlusion of the carotid artery without stenting. The groups of patients with stenting and risk controls had significantly reduced valsalva ratio and baroreflex sensitivity measured by the valsalva method compared to normal controls. However, there was no significant difference between patients with stenting and risk controls. There was significant decrease in heart rate response to deep breathing and to head-up tilt in patients with carotid stenting compared to normal controls. Other parameters of cardio-vascular autonomic function showed no difference among the three groups. Reduced baroreceptor function in patients with carotid stenting may be due to underlying diseases rather than the stenting itself. There was no short-term parasympathetic hyperactivity after the stenting, suggesting that the effect is transient rather than permanent.

      Keywords

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