Summary:
The incidence of cerebrovascular attacks (CVA) in diabetics is 2 - 3 times higher as compared with
the non-diabetic population. The objective of the present work was to evaluate etiological factors
by means of echocardiography and sonography of the carotid arteries. The authors evaluated
retrospectively findings of these examinations in 253 patients with CVA in a group of diabetic and
non-diabetic patients as well as in a group of patients with atrial fibrillations or sinus rhythm.
In patients with a sinus rhythm the presence of diabetes was associated with a more frequent
finding of atherosclerotic changes, significant stenoses of the carotid vessels (2 % as compared
with 8 %, p < 0.05) as well as thickness of the intima in the carotid bulbus (0.78 as compared with
0.96 mm, p < 0.05).Conversely when evaluating signs of thromboembolic risk , i.e. the size of the
left ventricle (42 vs. 40 mm, n.s.)and ejection fraction of the left ventricle (55 % vs. 50 %, n.s.) no
statistical significance in the difference of parameters was found.
In the sub-group of patients with atrial fibrillation, who accounted for 28 % of the group, the
authors did not find when comparing diabetic and non-diabetic patients, any difference as re-
gards the presence of significant stenoses in the carotid arteries nor in the thickness of the
intima. There was no statistically significant difference in the size of the left atrium and left
ventricular function.
The findings suggest the possibility that the increased risk of ischaemic CVA in diabetic patients
is caused by the atherosclerotic process in the carotid vessels and not a higher risk of embolism of
cardiac origin.
Key words:
Cerebrovascular attacks - Sonography of the carotid arteries - Echocardiography
|