Autonomic outcome is better after endarterectomy than after stenting in patients with asymptomatic carotid stenosis
Objective Carotid endarterectomy and stenting have comparable efficacy in stroke prevention in asymptomatic carotid stenosis. In patients with carotid stenosis, cardiac events have a more than threefold higher incidence than cerebrovascular events. Autonomic dysfunction predicts cardiovascular morbi...
Gespeichert in:
| Veröffentlicht in: | Journal of vascular surgery 2016-10, Vol.64 (4), p.975-984 |
|---|---|
| Hauptverfasser: | , , , , , , , |
| Format: | Artikel |
| Sprache: | eng |
| Schlagworte: | |
| Online-Zugang: | Volltext |
| Tags: |
Tag hinzufügen
Keine Tags, Fügen Sie den ersten Tag hinzu!
|
| container_end_page | 984 |
|---|---|
| container_issue | 4 |
| container_start_page | 975 |
| container_title | Journal of vascular surgery |
| container_volume | 64 |
| creator | Rupprecht, Sven, MD Finn, Sigrid, MD Ehrhardt, Jens, MSc Hoyer, Dirk, PhD Mayer, Thomas, PhD Zanow, Juergen, PhD Guenther, Albrecht, MD Schwab, Matthias, PhD |
| description | Objective Carotid endarterectomy and stenting have comparable efficacy in stroke prevention in asymptomatic carotid stenosis. In patients with carotid stenosis, cardiac events have a more than threefold higher incidence than cerebrovascular events. Autonomic dysfunction predicts cardiovascular morbidity and mortality, and carotid stenosis interferes with baroreceptor and chemoreceptor function. We assessed the effect of elective carotid revascularization (endarterectomy vs stenting) on autonomic function as a major prognostic factor of cardiovascular health. Methods In 42 patients with ≥70% asymptomatic extracranial carotid stenosis, autonomic function was determined by analysis of heart rate variability (total band power [TP], high frequency band power [HF], low-frequency band power [LF], very low frequency band power [VLF]), baroreflex sensitivity (αHF, αLF), respiratory chemoreflex sensitivity (central apnea-hypopnea index), and cardiac chemoreflex sensitivity (hyperoxic TP, HF, LF, and VLF ratios) before and 30 days after revascularization. Results Patients with endarterectomy were older than patients with stenting (69 ± 7 vs 62 ± 7 years; P ≤ .008) but did not differ in gender distribution and preintervention autonomic function. Compared with stenting, postintervention heart rate variability was higher (ln TP, 6.7 [95% confidence interval (CI), 6.3-7.0] vs 6.1 [95% CI, 5.8-6.5; P ≤ .009]; ln HF, 4.5 [95% CI, 4.1-5.0] vs 4.0 [95% CI, 3.4-4.5; P ≤ .05]; ln VLF, 6.0 [95% CI, 5.7-6.4] vs 5.5 [95% CI, 5.2-5.9; P ≤ .02]); respiratory chemoreflex sensitivity (central apnea-hypopnea index, 5.5 [95% CI, 2.8-8.2] vs 10.0 [95% CI, 6.9-13.1; P ≤. 01]) and cardiac chemoreflex sensitivity (TP ratio, 1.2 [95% CI, 1.1-1.3] vs 1.0 [95% CI, 0.9-1.0; P ≤ .0001]; HF ratio, 1.4 [95% CI, 1.2-1.5] vs 0.9 [95% CI, 0.8-1.1; P ≤ .001]; LF ratio, 1.5 [95% CI, 1.3-1.6] vs 1.0 [95% CI, 0.8-1.1; P ≤ .0001]; VLF ratio, 1.2 [95% CI, 1.1-1.3) vs 1.0 [95% CI, 0.9-1.1; P ≤ .002]) were lower after endarterectomy. Postintervention baroreflex sensitivity did not differ after endarterectomy and stenting. Conclusions Autonomic function was better after endarterectomy than after stenting. Better autonomic function after endarterectomy was based on restoration of chemoreceptor but not baroreceptor function and may improve cardiovascular long-term outcome. |
| doi_str_mv | 10.1016/j.jvs.2016.04.040 |
| format | Article |
| fullrecord | <record><control><sourceid>proquest_cross</sourceid><recordid>TN_cdi_proquest_miscellaneous_1823908474</recordid><sourceformat>XML</sourceformat><sourcesystem>PC</sourcesystem><els_id>1_s2_0_S0741521416301926</els_id><sourcerecordid>1823908474</sourcerecordid><originalsourceid>FETCH-LOGICAL-c451t-459d367d3198619f593a38e735ed03fb77dfe27320b88448acc8f842e023cefd3</originalsourceid><addsrcrecordid>eNp9kcFu1DAQhi0EotvCA3BBPnLJYsdO4ggJqaqgIFXqoeVsee0JdUjsxeMU7dvjsAsHDpVG9tj-_5HnG0LecLbljLfvx-34iNu6pFsmS7BnZMNZ31WtYv1zsmGd5FVTc3lGzhFHxjhvVPeSnNWdaIRo-g3ByyXHEGdvaVyyjTNQj3QHOUOiZlhXCM6kkoDNcT7Q_GDC6QUzhOzDd-oD3ZvsywnpL58fqMHDvC_ycmmpNSlm7_7II3p8RV4MZkJ4fdovyLfPn-6vvlQ3t9dfry5vKisbnivZ9E60nRO8Vy3vh6YXRigoXwfHxLDrOjdA6aRmO6WkVMZaNShZA6uFhcGJC_LuWHef4s8FMOvZo4VpMgHigpqrWvRMyU4WKT9KbYqICQa9T3426aA50ytrPerCWq-sNZMlWPG8PZVfdjO4f46_cIvgw1EApclHD0mjLYwsOL_C1C76J8t__M9tJx-8NdMPOACOcUmh0NNcY62ZvluHvc6at4Lxvm7Fb3bzpp4</addsrcrecordid><sourcetype>Aggregation Database</sourcetype><iscdi>true</iscdi><recordtype>article</recordtype><pqid>1823908474</pqid></control><display><type>article</type><title>Autonomic outcome is better after endarterectomy than after stenting in patients with asymptomatic carotid stenosis</title><source>MEDLINE</source><source>Elsevier ScienceDirect Journals</source><source>Elektronische Zeitschriftenbibliothek - Frei zugängliche E-Journals</source><creator>Rupprecht, Sven, MD ; Finn, Sigrid, MD ; Ehrhardt, Jens, MSc ; Hoyer, Dirk, PhD ; Mayer, Thomas, PhD ; Zanow, Juergen, PhD ; Guenther, Albrecht, MD ; Schwab, Matthias, PhD</creator><creatorcontrib>Rupprecht, Sven, MD ; Finn, Sigrid, MD ; Ehrhardt, Jens, MSc ; Hoyer, Dirk, PhD ; Mayer, Thomas, PhD ; Zanow, Juergen, PhD ; Guenther, Albrecht, MD ; Schwab, Matthias, PhD</creatorcontrib><description>Objective Carotid endarterectomy and stenting have comparable efficacy in stroke prevention in asymptomatic carotid stenosis. In patients with carotid stenosis, cardiac events have a more than threefold higher incidence than cerebrovascular events. Autonomic dysfunction predicts cardiovascular morbidity and mortality, and carotid stenosis interferes with baroreceptor and chemoreceptor function. We assessed the effect of elective carotid revascularization (endarterectomy vs stenting) on autonomic function as a major prognostic factor of cardiovascular health. Methods In 42 patients with ≥70% asymptomatic extracranial carotid stenosis, autonomic function was determined by analysis of heart rate variability (total band power [TP], high frequency band power [HF], low-frequency band power [LF], very low frequency band power [VLF]), baroreflex sensitivity (αHF, αLF), respiratory chemoreflex sensitivity (central apnea-hypopnea index), and cardiac chemoreflex sensitivity (hyperoxic TP, HF, LF, and VLF ratios) before and 30 days after revascularization. Results Patients with endarterectomy were older than patients with stenting (69 ± 7 vs 62 ± 7 years; P ≤ .008) but did not differ in gender distribution and preintervention autonomic function. Compared with stenting, postintervention heart rate variability was higher (ln TP, 6.7 [95% confidence interval (CI), 6.3-7.0] vs 6.1 [95% CI, 5.8-6.5; P ≤ .009]; ln HF, 4.5 [95% CI, 4.1-5.0] vs 4.0 [95% CI, 3.4-4.5; P ≤ .05]; ln VLF, 6.0 [95% CI, 5.7-6.4] vs 5.5 [95% CI, 5.2-5.9; P ≤ .02]); respiratory chemoreflex sensitivity (central apnea-hypopnea index, 5.5 [95% CI, 2.8-8.2] vs 10.0 [95% CI, 6.9-13.1; P ≤. 01]) and cardiac chemoreflex sensitivity (TP ratio, 1.2 [95% CI, 1.1-1.3] vs 1.0 [95% CI, 0.9-1.0; P ≤ .0001]; HF ratio, 1.4 [95% CI, 1.2-1.5] vs 0.9 [95% CI, 0.8-1.1; P ≤ .001]; LF ratio, 1.5 [95% CI, 1.3-1.6] vs 1.0 [95% CI, 0.8-1.1; P ≤ .0001]; VLF ratio, 1.2 [95% CI, 1.1-1.3) vs 1.0 [95% CI, 0.9-1.1; P ≤ .002]) were lower after endarterectomy. Postintervention baroreflex sensitivity did not differ after endarterectomy and stenting. Conclusions Autonomic function was better after endarterectomy than after stenting. Better autonomic function after endarterectomy was based on restoration of chemoreceptor but not baroreceptor function and may improve cardiovascular long-term outcome.</description><identifier>ISSN: 0741-5214</identifier><identifier>EISSN: 1097-6809</identifier><identifier>DOI: 10.1016/j.jvs.2016.04.040</identifier><identifier>PMID: 27353359</identifier><language>eng</language><publisher>United States: Elsevier Inc</publisher><subject>Aged ; Angioplasty - adverse effects ; Angioplasty - instrumentation ; Asymptomatic Diseases ; Autonomic Nervous System - physiopathology ; Baroreflex ; Carotid Stenosis - blood ; Carotid Stenosis - physiopathology ; Carotid Stenosis - surgery ; Carotid Stenosis - therapy ; Chemoreceptor Cells - metabolism ; Elective Surgical Procedures ; Endarterectomy, Carotid - adverse effects ; Female ; Heart - innervation ; Heart Rate ; Humans ; Longitudinal Studies ; Male ; Middle Aged ; Prospective Studies ; Risk Factors ; Severity of Illness Index ; Stents ; Surgery ; Time Factors ; Treatment Outcome</subject><ispartof>Journal of vascular surgery, 2016-10, Vol.64 (4), p.975-984</ispartof><rights>Society for Vascular Surgery</rights><rights>2016 Society for Vascular Surgery</rights><rights>Copyright © 2016 Society for Vascular Surgery. Published by Elsevier Inc. All rights reserved.</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c451t-459d367d3198619f593a38e735ed03fb77dfe27320b88448acc8f842e023cefd3</citedby><cites>FETCH-LOGICAL-c451t-459d367d3198619f593a38e735ed03fb77dfe27320b88448acc8f842e023cefd3</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktohtml>$$Uhttps://www.sciencedirect.com/science/article/pii/S0741521416301926$$EHTML$$P50$$Gelsevier$$Hfree_for_read</linktohtml><link.rule.ids>314,776,780,3536,27903,27904,65309</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/27353359$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Rupprecht, Sven, MD</creatorcontrib><creatorcontrib>Finn, Sigrid, MD</creatorcontrib><creatorcontrib>Ehrhardt, Jens, MSc</creatorcontrib><creatorcontrib>Hoyer, Dirk, PhD</creatorcontrib><creatorcontrib>Mayer, Thomas, PhD</creatorcontrib><creatorcontrib>Zanow, Juergen, PhD</creatorcontrib><creatorcontrib>Guenther, Albrecht, MD</creatorcontrib><creatorcontrib>Schwab, Matthias, PhD</creatorcontrib><title>Autonomic outcome is better after endarterectomy than after stenting in patients with asymptomatic carotid stenosis</title><title>Journal of vascular surgery</title><addtitle>J Vasc Surg</addtitle><description>Objective Carotid endarterectomy and stenting have comparable efficacy in stroke prevention in asymptomatic carotid stenosis. In patients with carotid stenosis, cardiac events have a more than threefold higher incidence than cerebrovascular events. Autonomic dysfunction predicts cardiovascular morbidity and mortality, and carotid stenosis interferes with baroreceptor and chemoreceptor function. We assessed the effect of elective carotid revascularization (endarterectomy vs stenting) on autonomic function as a major prognostic factor of cardiovascular health. Methods In 42 patients with ≥70% asymptomatic extracranial carotid stenosis, autonomic function was determined by analysis of heart rate variability (total band power [TP], high frequency band power [HF], low-frequency band power [LF], very low frequency band power [VLF]), baroreflex sensitivity (αHF, αLF), respiratory chemoreflex sensitivity (central apnea-hypopnea index), and cardiac chemoreflex sensitivity (hyperoxic TP, HF, LF, and VLF ratios) before and 30 days after revascularization. Results Patients with endarterectomy were older than patients with stenting (69 ± 7 vs 62 ± 7 years; P ≤ .008) but did not differ in gender distribution and preintervention autonomic function. Compared with stenting, postintervention heart rate variability was higher (ln TP, 6.7 [95% confidence interval (CI), 6.3-7.0] vs 6.1 [95% CI, 5.8-6.5; P ≤ .009]; ln HF, 4.5 [95% CI, 4.1-5.0] vs 4.0 [95% CI, 3.4-4.5; P ≤ .05]; ln VLF, 6.0 [95% CI, 5.7-6.4] vs 5.5 [95% CI, 5.2-5.9; P ≤ .02]); respiratory chemoreflex sensitivity (central apnea-hypopnea index, 5.5 [95% CI, 2.8-8.2] vs 10.0 [95% CI, 6.9-13.1; P ≤. 01]) and cardiac chemoreflex sensitivity (TP ratio, 1.2 [95% CI, 1.1-1.3] vs 1.0 [95% CI, 0.9-1.0; P ≤ .0001]; HF ratio, 1.4 [95% CI, 1.2-1.5] vs 0.9 [95% CI, 0.8-1.1; P ≤ .001]; LF ratio, 1.5 [95% CI, 1.3-1.6] vs 1.0 [95% CI, 0.8-1.1; P ≤ .0001]; VLF ratio, 1.2 [95% CI, 1.1-1.3) vs 1.0 [95% CI, 0.9-1.1; P ≤ .002]) were lower after endarterectomy. Postintervention baroreflex sensitivity did not differ after endarterectomy and stenting. Conclusions Autonomic function was better after endarterectomy than after stenting. Better autonomic function after endarterectomy was based on restoration of chemoreceptor but not baroreceptor function and may improve cardiovascular long-term outcome.</description><subject>Aged</subject><subject>Angioplasty - adverse effects</subject><subject>Angioplasty - instrumentation</subject><subject>Asymptomatic Diseases</subject><subject>Autonomic Nervous System - physiopathology</subject><subject>Baroreflex</subject><subject>Carotid Stenosis - blood</subject><subject>Carotid Stenosis - physiopathology</subject><subject>Carotid Stenosis - surgery</subject><subject>Carotid Stenosis - therapy</subject><subject>Chemoreceptor Cells - metabolism</subject><subject>Elective Surgical Procedures</subject><subject>Endarterectomy, Carotid - adverse effects</subject><subject>Female</subject><subject>Heart - innervation</subject><subject>Heart Rate</subject><subject>Humans</subject><subject>Longitudinal Studies</subject><subject>Male</subject><subject>Middle Aged</subject><subject>Prospective Studies</subject><subject>Risk Factors</subject><subject>Severity of Illness Index</subject><subject>Stents</subject><subject>Surgery</subject><subject>Time Factors</subject><subject>Treatment Outcome</subject><issn>0741-5214</issn><issn>1097-6809</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2016</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><recordid>eNp9kcFu1DAQhi0EotvCA3BBPnLJYsdO4ggJqaqgIFXqoeVsee0JdUjsxeMU7dvjsAsHDpVG9tj-_5HnG0LecLbljLfvx-34iNu6pFsmS7BnZMNZ31WtYv1zsmGd5FVTc3lGzhFHxjhvVPeSnNWdaIRo-g3ByyXHEGdvaVyyjTNQj3QHOUOiZlhXCM6kkoDNcT7Q_GDC6QUzhOzDd-oD3ZvsywnpL58fqMHDvC_ycmmpNSlm7_7II3p8RV4MZkJ4fdovyLfPn-6vvlQ3t9dfry5vKisbnivZ9E60nRO8Vy3vh6YXRigoXwfHxLDrOjdA6aRmO6WkVMZaNShZA6uFhcGJC_LuWHef4s8FMOvZo4VpMgHigpqrWvRMyU4WKT9KbYqICQa9T3426aA50ytrPerCWq-sNZMlWPG8PZVfdjO4f46_cIvgw1EApclHD0mjLYwsOL_C1C76J8t__M9tJx-8NdMPOACOcUmh0NNcY62ZvluHvc6at4Lxvm7Fb3bzpp4</recordid><startdate>20161001</startdate><enddate>20161001</enddate><creator>Rupprecht, Sven, MD</creator><creator>Finn, Sigrid, MD</creator><creator>Ehrhardt, Jens, MSc</creator><creator>Hoyer, Dirk, PhD</creator><creator>Mayer, Thomas, PhD</creator><creator>Zanow, Juergen, PhD</creator><creator>Guenther, Albrecht, MD</creator><creator>Schwab, Matthias, PhD</creator><general>Elsevier Inc</general><scope>6I.</scope><scope>AAFTH</scope><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7X8</scope></search><sort><creationdate>20161001</creationdate><title>Autonomic outcome is better after endarterectomy than after stenting in patients with asymptomatic carotid stenosis</title><author>Rupprecht, Sven, MD ; Finn, Sigrid, MD ; Ehrhardt, Jens, MSc ; Hoyer, Dirk, PhD ; Mayer, Thomas, PhD ; Zanow, Juergen, PhD ; Guenther, Albrecht, MD ; Schwab, Matthias, PhD</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c451t-459d367d3198619f593a38e735ed03fb77dfe27320b88448acc8f842e023cefd3</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2016</creationdate><topic>Aged</topic><topic>Angioplasty - adverse effects</topic><topic>Angioplasty - instrumentation</topic><topic>Asymptomatic Diseases</topic><topic>Autonomic Nervous System - physiopathology</topic><topic>Baroreflex</topic><topic>Carotid Stenosis - blood</topic><topic>Carotid Stenosis - physiopathology</topic><topic>Carotid Stenosis - surgery</topic><topic>Carotid Stenosis - therapy</topic><topic>Chemoreceptor Cells - metabolism</topic><topic>Elective Surgical Procedures</topic><topic>Endarterectomy, Carotid - adverse effects</topic><topic>Female</topic><topic>Heart - innervation</topic><topic>Heart Rate</topic><topic>Humans</topic><topic>Longitudinal Studies</topic><topic>Male</topic><topic>Middle Aged</topic><topic>Prospective Studies</topic><topic>Risk Factors</topic><topic>Severity of Illness Index</topic><topic>Stents</topic><topic>Surgery</topic><topic>Time Factors</topic><topic>Treatment Outcome</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Rupprecht, Sven, MD</creatorcontrib><creatorcontrib>Finn, Sigrid, MD</creatorcontrib><creatorcontrib>Ehrhardt, Jens, MSc</creatorcontrib><creatorcontrib>Hoyer, Dirk, PhD</creatorcontrib><creatorcontrib>Mayer, Thomas, PhD</creatorcontrib><creatorcontrib>Zanow, Juergen, PhD</creatorcontrib><creatorcontrib>Guenther, Albrecht, MD</creatorcontrib><creatorcontrib>Schwab, Matthias, PhD</creatorcontrib><collection>ScienceDirect Open Access Titles</collection><collection>Elsevier:ScienceDirect:Open Access</collection><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>MEDLINE - Academic</collection><jtitle>Journal of vascular surgery</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Rupprecht, Sven, MD</au><au>Finn, Sigrid, MD</au><au>Ehrhardt, Jens, MSc</au><au>Hoyer, Dirk, PhD</au><au>Mayer, Thomas, PhD</au><au>Zanow, Juergen, PhD</au><au>Guenther, Albrecht, MD</au><au>Schwab, Matthias, PhD</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Autonomic outcome is better after endarterectomy than after stenting in patients with asymptomatic carotid stenosis</atitle><jtitle>Journal of vascular surgery</jtitle><addtitle>J Vasc Surg</addtitle><date>2016-10-01</date><risdate>2016</risdate><volume>64</volume><issue>4</issue><spage>975</spage><epage>984</epage><pages>975-984</pages><issn>0741-5214</issn><eissn>1097-6809</eissn><abstract>Objective Carotid endarterectomy and stenting have comparable efficacy in stroke prevention in asymptomatic carotid stenosis. In patients with carotid stenosis, cardiac events have a more than threefold higher incidence than cerebrovascular events. Autonomic dysfunction predicts cardiovascular morbidity and mortality, and carotid stenosis interferes with baroreceptor and chemoreceptor function. We assessed the effect of elective carotid revascularization (endarterectomy vs stenting) on autonomic function as a major prognostic factor of cardiovascular health. Methods In 42 patients with ≥70% asymptomatic extracranial carotid stenosis, autonomic function was determined by analysis of heart rate variability (total band power [TP], high frequency band power [HF], low-frequency band power [LF], very low frequency band power [VLF]), baroreflex sensitivity (αHF, αLF), respiratory chemoreflex sensitivity (central apnea-hypopnea index), and cardiac chemoreflex sensitivity (hyperoxic TP, HF, LF, and VLF ratios) before and 30 days after revascularization. Results Patients with endarterectomy were older than patients with stenting (69 ± 7 vs 62 ± 7 years; P ≤ .008) but did not differ in gender distribution and preintervention autonomic function. Compared with stenting, postintervention heart rate variability was higher (ln TP, 6.7 [95% confidence interval (CI), 6.3-7.0] vs 6.1 [95% CI, 5.8-6.5; P ≤ .009]; ln HF, 4.5 [95% CI, 4.1-5.0] vs 4.0 [95% CI, 3.4-4.5; P ≤ .05]; ln VLF, 6.0 [95% CI, 5.7-6.4] vs 5.5 [95% CI, 5.2-5.9; P ≤ .02]); respiratory chemoreflex sensitivity (central apnea-hypopnea index, 5.5 [95% CI, 2.8-8.2] vs 10.0 [95% CI, 6.9-13.1; P ≤. 01]) and cardiac chemoreflex sensitivity (TP ratio, 1.2 [95% CI, 1.1-1.3] vs 1.0 [95% CI, 0.9-1.0; P ≤ .0001]; HF ratio, 1.4 [95% CI, 1.2-1.5] vs 0.9 [95% CI, 0.8-1.1; P ≤ .001]; LF ratio, 1.5 [95% CI, 1.3-1.6] vs 1.0 [95% CI, 0.8-1.1; P ≤ .0001]; VLF ratio, 1.2 [95% CI, 1.1-1.3) vs 1.0 [95% CI, 0.9-1.1; P ≤ .002]) were lower after endarterectomy. Postintervention baroreflex sensitivity did not differ after endarterectomy and stenting. Conclusions Autonomic function was better after endarterectomy than after stenting. Better autonomic function after endarterectomy was based on restoration of chemoreceptor but not baroreceptor function and may improve cardiovascular long-term outcome.</abstract><cop>United States</cop><pub>Elsevier Inc</pub><pmid>27353359</pmid><doi>10.1016/j.jvs.2016.04.040</doi><tpages>10</tpages><oa>free_for_read</oa></addata></record> |
| fulltext | fulltext |
| identifier | ISSN: 0741-5214 |
| ispartof | Journal of vascular surgery, 2016-10, Vol.64 (4), p.975-984 |
| issn | 0741-5214 1097-6809 |
| language | eng |
| recordid | cdi_proquest_miscellaneous_1823908474 |
| source | MEDLINE; Elsevier ScienceDirect Journals; Elektronische Zeitschriftenbibliothek - Frei zugängliche E-Journals |
| subjects | Aged Angioplasty - adverse effects Angioplasty - instrumentation Asymptomatic Diseases Autonomic Nervous System - physiopathology Baroreflex Carotid Stenosis - blood Carotid Stenosis - physiopathology Carotid Stenosis - surgery Carotid Stenosis - therapy Chemoreceptor Cells - metabolism Elective Surgical Procedures Endarterectomy, Carotid - adverse effects Female Heart - innervation Heart Rate Humans Longitudinal Studies Male Middle Aged Prospective Studies Risk Factors Severity of Illness Index Stents Surgery Time Factors Treatment Outcome |
| title | Autonomic outcome is better after endarterectomy than after stenting in patients with asymptomatic carotid stenosis |
| url | https://sfx.bib-bvb.de/sfx_tum?ctx_ver=Z39.88-2004&ctx_enc=info:ofi/enc:UTF-8&ctx_tim=2025-01-24T04%3A37%3A38IST&url_ver=Z39.88-2004&url_ctx_fmt=infofi/fmt:kev:mtx:ctx&rfr_id=info:sid/primo.exlibrisgroup.com:primo3-Article-proquest_cross&rft_val_fmt=info:ofi/fmt:kev:mtx:journal&rft.genre=article&rft.atitle=Autonomic%20outcome%20is%20better%20after%20endarterectomy%20than%20after%20stenting%20in%20patients%20with%20asymptomatic%20carotid%20stenosis&rft.jtitle=Journal%20of%20vascular%20surgery&rft.au=Rupprecht,%20Sven,%20MD&rft.date=2016-10-01&rft.volume=64&rft.issue=4&rft.spage=975&rft.epage=984&rft.pages=975-984&rft.issn=0741-5214&rft.eissn=1097-6809&rft_id=info:doi/10.1016/j.jvs.2016.04.040&rft_dat=%3Cproquest_cross%3E1823908474%3C/proquest_cross%3E%3Curl%3E%3C/url%3E&disable_directlink=true&sfx.directlink=off&sfx.report_link=0&rft_id=info:oai/&rft_pqid=1823908474&rft_id=info:pmid/27353359&rft_els_id=1_s2_0_S0741521416301926&rfr_iscdi=true |