EUROECHO 2013 -- The Seventeenth Annual Meeting of the European Association of Echocardiography 11-14 December, Istanbul, Turkey

Incidence of chronic cerebrospinal venous insufficiency in multiple sclerosis: patients vs. first degree relatives and healthy controls F.L. Ciciarello, L. Agati, S. Cimino, L. De Luca, V. Petronilli, F. Fedele (Rome, IT)

Abstract Background: Chronic cerebrospinal venous insufficiency (CCSVI) is a new vascular pattern recently associated with multiple sclerosis (MS). Aim of this study was to assess the presence of CCSVI parameter and vascular abnormalities, in the Internal Jugular Veins (IJVs) and/or Vertebral Veins (VVs) in sitting and supine posture, in MS patients versus first degree relatives with MS familiarity and general population. Methods: We investigated in 272 MS patients, in 118 first degree relative of MS patients and in 97 healthy controls, morphologic and hemodynamic venous abnormalities of the IJVs and/or VVs by means of high resolution B-mode ultrasounds. Diagnostic five parameters recently approved in a consensus conference were calculated in both supine and sitting positions. Results: CCSVI showed positiveness for at least 2 criteria in 179/272 (83%) MS patients, in 24/118 (20%) first degree relatives and in 24/97 (25%) of healthy controls. MS patients showed a statistically significant higher incidence of reflux in the intracranial veins (parameter two) versus first degree relatives and controls (51% vs. 16% and 12%, respectively, p<0.001) and also higher number of IJVs hemodynamic but not morphologically significant stenosis (62% vs. 41% and 37%, p<0.01). The other parameters did not show statistically significant differences among the three groups except for a greater incidence of venous abnormalities in MS patients (septa, membranes or intraluminal defects); no correlation was found between the severity of CCSVI and MS clinical form. Conclusions: CCSVI is a new cerebrospinal venous system disease recently associated with MS, however these venous abnormalities are also present, even less frequently, in first degree relatives and in healthy controls. When analyzing the influence of hemodynamic stenosis on cerebral flow drainage, only intracranial veins reflux was highly statistically significant. CCSVI transversely crosses the entire general population, but the largest number of intraluminal defects of the veins observed in MS patients (septa, membranes, immobile or hypoplastic valves) could lead to stenosis or obstruction in the IJVs and other veins, contributing to the development or exacerbation of multiple sclerosis. Future larger studies are needed to assess the definite correlation between these venous abnormalities and multiple sclerosis and also to assess their role in the general population.

Source: http://www.escardio.org/congresses/euroecho2013/Documents/final-programme.pdf


http://www.escardio.org/congresses/euroecho2013/Documents/final-programme.pdf
www.escardio.org