Relação da espessura médio-intimal das artérias femorais com doença arterial periférica

Detalhes bibliográficos
Ano de defesa: 2022
Autor(a) principal: Diógenes, Camilo de Alencar
Orientador(a): Silva, Ricardo Pereira
Banca de defesa: Não Informado pela instituição
Tipo de documento: Dissertação
Tipo de acesso: Acesso aberto
Idioma: por
Instituição de defesa: Não Informado pela instituição
Programa de Pós-Graduação: Não Informado pela instituição
Departamento: Não Informado pela instituição
País: Não Informado pela instituição
Palavras-chave em Português:
Link de acesso: http://www.repositorio.ufc.br/handle/riufc/70017
Resumo: Introduction: Peripheral arterial disease (PAD) is one of the cardiovascular diseases, in addition to cerebrovascular and coronary ischemic diseases. It is related to arterial atherosclerotic involvement of the lower limbs and determines high morbidity and mortality when not properly diagnosed and treated. Its diagnosis is made through clinical and imaging tests, with the ankle-brachial index being an important diagnostic tool. The index is only altered when the disease is installed, unlike the intima-media thickness (IMT), which may undergo early changes in the course of atherosclerotic disease. Carotid IMT has been widely studied and corresponds to an important marker of systemic atherosclerosis. The present study intends to evaluate the IMT of the femoral arteries and its relationship with PAD. Methods: The research consists of a cross-sectional epidemiological study carried out at the Walter Cantídio University Hospital with a descriptive and analytical approach. Measurements were obtained using B-mode ultrasonography (US) of the IMT of the femoral arteries in eighty-one patients with PAD and eighty-three patients without the disease. Information was collected regarding age, gender and modifiable cardiovascular risk factors, diabetes, hypertension, smoking and dyslipidemia. The measures obtained in the two groups and among the participants of the same group were then compared according to the determined variables. A comparison of arteriography findings of the lower limbs of patients with PAD with cardiovascular risk factors was also performed. Results: There was a significant difference in femoral IMT between participants in both groups, with a mean of 1.22 ± 0.19 mm in the DAP group and 0.85 ± 0.18 mm in the control group (p < 0.01). In addition to the presence of PAD, age and the number of cardiovascular risk factors were strongly associated with higher values of femoral IMT. Regarding the location of the atherosclerotic lesions in patients in the PAD group, it was observed that smoking was more associated with proximal lesions (iliac segment), while diabetes was more associated with distal lesions (tibial-fibular segment). Conclusion: The study demonstrates a positive relationship between femoral IMT and peripheral atherosclerotic disease, considering the higher values obtained in the PAD group. Additional findings observed that age and presence of cardiovascular risk factors were associated with higher values of femoral IMT. Measurement of femoral IMT with US demonstrated good reproducibility and an easy-to-perform technique, which could become a direct complement to the vascular physical examination of the lower limbs. We conclude that patients with increased femoral IMT, even if asymptomatic and with no abnormalities on clinical examination, deserve special attention because of the greater risk of developing PAD over the years.
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spelling Diógenes, Camilo de AlencarSilva, Ricardo Pereira2023-01-09T15:57:01Z2023-01-09T15:57:01Z2022DIOGENES, C. A. Relação da espessura médio-intimal das artérias femorais com doença arterial periférica. 2022. 34 f. Dissertação (Mestrado em Ciências Cardiovasculares) - Faculdade de Medicina, Universidade Federal do Ceará, Fortaleza, 2022. Disponível em: http://www.repositorio.ufc.br/handle/riufc/70017. Acesso em: 09 jan. 2023.http://www.repositorio.ufc.br/handle/riufc/70017Introduction: Peripheral arterial disease (PAD) is one of the cardiovascular diseases, in addition to cerebrovascular and coronary ischemic diseases. It is related to arterial atherosclerotic involvement of the lower limbs and determines high morbidity and mortality when not properly diagnosed and treated. Its diagnosis is made through clinical and imaging tests, with the ankle-brachial index being an important diagnostic tool. The index is only altered when the disease is installed, unlike the intima-media thickness (IMT), which may undergo early changes in the course of atherosclerotic disease. Carotid IMT has been widely studied and corresponds to an important marker of systemic atherosclerosis. The present study intends to evaluate the IMT of the femoral arteries and its relationship with PAD. Methods: The research consists of a cross-sectional epidemiological study carried out at the Walter Cantídio University Hospital with a descriptive and analytical approach. Measurements were obtained using B-mode ultrasonography (US) of the IMT of the femoral arteries in eighty-one patients with PAD and eighty-three patients without the disease. Information was collected regarding age, gender and modifiable cardiovascular risk factors, diabetes, hypertension, smoking and dyslipidemia. The measures obtained in the two groups and among the participants of the same group were then compared according to the determined variables. A comparison of arteriography findings of the lower limbs of patients with PAD with cardiovascular risk factors was also performed. Results: There was a significant difference in femoral IMT between participants in both groups, with a mean of 1.22 ± 0.19 mm in the DAP group and 0.85 ± 0.18 mm in the control group (p < 0.01). In addition to the presence of PAD, age and the number of cardiovascular risk factors were strongly associated with higher values of femoral IMT. Regarding the location of the atherosclerotic lesions in patients in the PAD group, it was observed that smoking was more associated with proximal lesions (iliac segment), while diabetes was more associated with distal lesions (tibial-fibular segment). Conclusion: The study demonstrates a positive relationship between femoral IMT and peripheral atherosclerotic disease, considering the higher values obtained in the PAD group. Additional findings observed that age and presence of cardiovascular risk factors were associated with higher values of femoral IMT. Measurement of femoral IMT with US demonstrated good reproducibility and an easy-to-perform technique, which could become a direct complement to the vascular physical examination of the lower limbs. We conclude that patients with increased femoral IMT, even if asymptomatic and with no abnormalities on clinical examination, deserve special attention because of the greater risk of developing PAD over the years.Introdução: A doença arterial periférica (DAP) faz parte do grupo das doenças cardiovasculares, juntamente com doença cérebro-vascular e isquêmica coronariana. Está relacionada ao acometimento aterosclerótico arterial dos membros inferiores e determina elevada morbimortalidade quando não adequadamente diagnosticada e tratada. Seu diagnóstico é realizado por meio de testes clínicos e de imagem, sendo o índice tornozelo-braquial uma importante ferramenta diagnóstica. O índice só está alterado quando da doença instalada, ao contrário da espessura médio-intimal (EMI), que pode sofrer alterações precoces no curso da doença aterosclerótica. A EMI das carótidas já foi amplamente estudada e corresponde a um importante marcador de aterosclerose sistêmica. O presente trabalho pretende avaliar a EMI das artérias femorais e sua relação com a DAP. Métodos: A pesquisa consiste em um estudo epidemiológico transversal realizado no Hospital Universitário Walter Cantídio com abordagem descritiva e analítica. Foram obtidas medidas, através de ultrassonografia (US) modo B, de EMI das artérias femorais de oitenta e um pacientes com DAP e de oitenta e três pacientes sem a doença. Foram coletadas informações quanto a idade, gênero e fatores de risco cardiovascular modificáveis, diabetes, hipertensão, tabagismo e dislipidemia. Foram então comparadas as medidas obtidas nos dois grupos e entre os participantes do mesmo grupo de acordo com as variáveis em estudo. Foi feito ainda a comparação dos achados de arteriografia dos membros inferiores de pacientes com DAP com os fatores de risco cardiovasculares. Resultados: Observou-se diferença expressiva de EMI femoral entre os participantes dos dois grupos, com média de 1,22 ± 0,19 mm no grupo DAP e de 0,85 ± 0,18 mm no grupo controle (p < 0,01). Além da presença de DAP, a idade e a quantidade de fatores de risco cardiovasculares apresentaram forte associação com maiores valores de EMI femoral. Em relação ao local de lesões ateroscleróticas nos pacientes do grupo DAP, observou-se que tabagismo esteve associado a maior comprometimento proximal (segmento ilíaco) enquanto diabetes determinou maior comprometimento distal (segmento tíbio-fibular). Conclusão: O trabalho demonstra relação positiva da EMI femoral com doença aterosclerótica periférica, tendo em vista os maiores valores obtidos no grupo DAP. Achados adicionais observaram que a idade e presença de fatores de risco cardiovasculares estiveram associados a maiores valores de EMI femoral. A mensuração da EMI femoral com US demonstrou boa reprodutibilidade e técnica de fácil execução, podendo se tornar um complemento direto do exame físico vascular dos membros inferiores. Concluímos que pacientes com aumento da EMI femoral, mesmo que assintomáticos e com exame clínico sem anormalidades, merecem atenção especial pelo maior risco de desenvolver DAP no decorrer dos anos.Doença Arterial PeriféricaArtériasDoenças CardiovascularesFatores de Risco de Doenças CardíacasRelação da espessura médio-intimal das artérias femorais com doença arterial periféricainfo:eu-repo/semantics/publishedVersioninfo:eu-repo/semantics/masterThesisporreponame:Repositório Institucional da Universidade Federal do Ceará (UFC)instname:Universidade Federal do Ceará (UFC)instacron:UFCinfo:eu-repo/semantics/openAccessORIGINAL2022_dis_cadiogenes.pdf2022_dis_cadiogenes.pdfapplication/pdf1579352http://repositorio.ufc.br/bitstream/riufc/70017/1/2022_dis_cadiogenes.pdf027b0e6043ba6f233924fc075f82b225MD51LICENSElicense.txtlicense.txttext/plain; charset=utf-81748http://repositorio.ufc.br/bitstream/riufc/70017/2/license.txt8a4605be74aa9ea9d79846c1fba20a33MD52riufc/700172023-01-09 13:20:50.398oai:repositorio.ufc.br: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Repositório InstitucionalPUBhttp://www.repositorio.ufc.br/ri-oai/requestbu@ufc.br || repositorio@ufc.bropendoar:2023-01-09T16:20:50Repositório Institucional da Universidade Federal do Ceará (UFC) - Universidade Federal do Ceará (UFC)false
dc.title.pt_BR.fl_str_mv Relação da espessura médio-intimal das artérias femorais com doença arterial periférica
title Relação da espessura médio-intimal das artérias femorais com doença arterial periférica
spellingShingle Relação da espessura médio-intimal das artérias femorais com doença arterial periférica
Diógenes, Camilo de Alencar
Doença Arterial Periférica
Artérias
Doenças Cardiovasculares
Fatores de Risco de Doenças Cardíacas
title_short Relação da espessura médio-intimal das artérias femorais com doença arterial periférica
title_full Relação da espessura médio-intimal das artérias femorais com doença arterial periférica
title_fullStr Relação da espessura médio-intimal das artérias femorais com doença arterial periférica
title_full_unstemmed Relação da espessura médio-intimal das artérias femorais com doença arterial periférica
title_sort Relação da espessura médio-intimal das artérias femorais com doença arterial periférica
author Diógenes, Camilo de Alencar
author_facet Diógenes, Camilo de Alencar
author_role author
dc.contributor.author.fl_str_mv Diógenes, Camilo de Alencar
dc.contributor.advisor1.fl_str_mv Silva, Ricardo Pereira
contributor_str_mv Silva, Ricardo Pereira
dc.subject.por.fl_str_mv Doença Arterial Periférica
Artérias
Doenças Cardiovasculares
Fatores de Risco de Doenças Cardíacas
topic Doença Arterial Periférica
Artérias
Doenças Cardiovasculares
Fatores de Risco de Doenças Cardíacas
description Introduction: Peripheral arterial disease (PAD) is one of the cardiovascular diseases, in addition to cerebrovascular and coronary ischemic diseases. It is related to arterial atherosclerotic involvement of the lower limbs and determines high morbidity and mortality when not properly diagnosed and treated. Its diagnosis is made through clinical and imaging tests, with the ankle-brachial index being an important diagnostic tool. The index is only altered when the disease is installed, unlike the intima-media thickness (IMT), which may undergo early changes in the course of atherosclerotic disease. Carotid IMT has been widely studied and corresponds to an important marker of systemic atherosclerosis. The present study intends to evaluate the IMT of the femoral arteries and its relationship with PAD. Methods: The research consists of a cross-sectional epidemiological study carried out at the Walter Cantídio University Hospital with a descriptive and analytical approach. Measurements were obtained using B-mode ultrasonography (US) of the IMT of the femoral arteries in eighty-one patients with PAD and eighty-three patients without the disease. Information was collected regarding age, gender and modifiable cardiovascular risk factors, diabetes, hypertension, smoking and dyslipidemia. The measures obtained in the two groups and among the participants of the same group were then compared according to the determined variables. A comparison of arteriography findings of the lower limbs of patients with PAD with cardiovascular risk factors was also performed. Results: There was a significant difference in femoral IMT between participants in both groups, with a mean of 1.22 ± 0.19 mm in the DAP group and 0.85 ± 0.18 mm in the control group (p < 0.01). In addition to the presence of PAD, age and the number of cardiovascular risk factors were strongly associated with higher values of femoral IMT. Regarding the location of the atherosclerotic lesions in patients in the PAD group, it was observed that smoking was more associated with proximal lesions (iliac segment), while diabetes was more associated with distal lesions (tibial-fibular segment). Conclusion: The study demonstrates a positive relationship between femoral IMT and peripheral atherosclerotic disease, considering the higher values obtained in the PAD group. Additional findings observed that age and presence of cardiovascular risk factors were associated with higher values of femoral IMT. Measurement of femoral IMT with US demonstrated good reproducibility and an easy-to-perform technique, which could become a direct complement to the vascular physical examination of the lower limbs. We conclude that patients with increased femoral IMT, even if asymptomatic and with no abnormalities on clinical examination, deserve special attention because of the greater risk of developing PAD over the years.
publishDate 2022
dc.date.issued.fl_str_mv 2022
dc.date.accessioned.fl_str_mv 2023-01-09T15:57:01Z
dc.date.available.fl_str_mv 2023-01-09T15:57:01Z
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dc.identifier.citation.fl_str_mv DIOGENES, C. A. Relação da espessura médio-intimal das artérias femorais com doença arterial periférica. 2022. 34 f. Dissertação (Mestrado em Ciências Cardiovasculares) - Faculdade de Medicina, Universidade Federal do Ceará, Fortaleza, 2022. Disponível em: http://www.repositorio.ufc.br/handle/riufc/70017. Acesso em: 09 jan. 2023.
dc.identifier.uri.fl_str_mv http://www.repositorio.ufc.br/handle/riufc/70017
identifier_str_mv DIOGENES, C. A. Relação da espessura médio-intimal das artérias femorais com doença arterial periférica. 2022. 34 f. Dissertação (Mestrado em Ciências Cardiovasculares) - Faculdade de Medicina, Universidade Federal do Ceará, Fortaleza, 2022. Disponível em: http://www.repositorio.ufc.br/handle/riufc/70017. Acesso em: 09 jan. 2023.
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