cardiovascularКардиоваскулярная терапия и профилактикаCardiovascular Therapy and Prevention1728-88002619-0125«SILICEA-POLIGRAF» LLC10.15829/1728-8800-2013-2-63-69cardiovascular-178Research ArticleАТЕРОСКЛЕРОЗATHEROSCLEROSISЧАСТОТА ДИАГНОСТИКИ АТЕРОСКЛЕРОТИЧЕСКОГО ПОРАЖЕНИЯ НЕСКОЛЬКИХ СОСУДИСТЫХ БАССЕЙНОВ В РАЗЛИЧНЫХ ВОЗРАСТНЫХ ГРУППАХPREVALENCE OF MULTI-FOCAL ATHEROSCLEROTIC PATHOLOGY ACROSS AGE GROUPSСуминА. Н.SuminA. N.

д. м.н., и. о. заведующего отделом мультифокального атеросклероза, заведующий лабораторией патологии кровообращения

Тел.: (3842) 64–44–61; факс: (3842) 64–27–18

sumian@cardio.kem.ruГайфулинР. А.GaifullinR. A.

к. м.н., н. с. лаборатории интервенционных методов диагностики и лечения

БезденежныхА. В.BezdenezhnykhA. V.

н. с. лаборатории патологии кровообращения

КорокЕ. В.KorokE. V.

н. с. лаборатории патологии кровообращения

КарповичА. В.KarpovichA. V.

м. н.с. лаборатории патологии кровообращения

ИвановС. В.IvanovS. V.

д. м.н., заведующий лабораторией реконструктивной хирургии

БарбарашО. Л.BarbarashO. L.

д. м.н., профессор, директор

Барбараш Л. С.Л. С.BarbarashL. S.

академик РАМН, главный научный сотрудник

ФГБУ «Научно-исследовательский институт комплексных проблем сердечно-сосудистых заболеваний» СО РАМН, КемеровоRussian Federation2013200420131226369Copyright © Сумин А.Н., Гайфулин Р.А., Безденежных А.В., Корок Е.В., Карпович А.В., Иванов С.В., Барбараш О.Л., Барбараш Л. С. Л.С., 20132013Сумин А.Н., Гайфулин Р.А., Безденежных А.В., Корок Е.В., Карпович А.В., Иванов С.В., Барбараш О.Л., Барбараш Л. С. Л.С.Sumin A.N., Gaifullin R.A., Bezdenezhnykh A.V., Korok E.V., Karpovich A.V., Ivanov S.V., Barbarash O.L., Barbarash L.S.Данная работа распространяется под лицензией Creative Commons Attribution 4.0.This work is licensed under a Creative Commons Attribution 4.0 License.https://cardiovascular.elpub.ru/jour/article/view/178Цель

Цель. Изучение частоты выявления субклинических атеросклеротических изменений в нескольких артериальных бассейнах и фак- торов, влияющих на их распространенность в различных возрастных группах (гр.) у больных клиники сердечно-сосудистой хирургии.

Материал и методы

Материал и методы. В исследование включены 1018 пациентов: 825 мужчин и 193 женщин, средний возраст 59,0±12,0 лет, в период подготовки к плановым вмешательствам на коронарных артериях (КА) и других артериальных бассейнах. Выделены 4 гр.: I гр. — больные < 60 лет (n=542), II гр. — 60–64 лет (n=215), III гр. — 65–69 лет (n=141), IV гр. — больные ≥ 70 лет (n=120). Коронароангиография и допплеровское ультразвуковое исследование экстракраниальных артерий проводились всем пациентам, при необходимости — ангиография периферических артерий. Критерием мультифокального атеросклероза (МФА) было наличие стенозов ≥30% или операции реваскуляризации в ≥2 сосудистых бассейнах.

Результаты

Результаты. Субклинические атеросклеротические поражения в различных сосудистых бассейнах выявлены у 52,3% пациентов. С возрастом частота определения МФА возрастала с 45,8% в I гр. до 58,6% — во II, 58,2% — в III и 63,3% — в IV гр. (р=0,0001). Если в I гр. наличие МФА ассоциировалось с синдромом перемежающейся хромоты (СПХ), снижением индекса массы тела (ИМТ), увеличением толщины комплекса интима-медиа (ТКИМ) и уровня общего холестерина (ОХС), то у больных II–IV гр. — только с СПХ.

Заключение

Заключение. При учете субклинических (гемодинамически незначимых) поражений в артериальных бассейнах выявлено увеличение числа больных с МФА. Увеличение возраста ассоциировалось с МФА. Факторами, связанными с МФА, были увеличение ТКИМ и уровня ОХС, наличие СПХ и снижение ИМТ. 

Aim

Aim. To compare the prevalence of multi-focal subclinical atherosclerotic pathology and its determinants in cardiovascular surgery patients.

Material and methods

Material and methods. The study included 1018 patients — 825 en and 193 women (mean age 59,0±12,0 years) — who were hospitalised for a planned intervention on coronary or other arteries. Group I (n=542) was aged under 60 years, Group II (n=215) — 60–64 years, Group III (n=141) — 65–69 years, and Group IV (n=120) — 70 years or older. All participants underwent coronary angiography and Doppler ultrasound; peripheral angiography was performed, if necessary. Multi-focal atherosclerosis (MFA) criteria were the presence of stenosis (≥30%) or revascularisation in two or more vascular territories.

Results

Results. Subclinical atherosclerotic pathology of various localisation was observed in 52,3% of the patients. Advanced age was linked to an increase in the MFA prevalence: from 45,8% in Group I to 58,6% in Group II, 58,2% in Group III, and 63,3% in Group IV (p=0,0001). In Group I, MFA was associated with the intermittent claudication syndrome (ICS), decreased body mass index (BMI), increased intima-media thickness (IMT), elevated total cholesterol (TCH). However, in Groups II–IV, the only association observed was between MFA and ICS.

Conclusion

Conclusion. Taking into account the subclinical (hemodynamically insignificant) arterial pathology had resulted in a high prevalence of MFA. Advanced age was associated with a higher MFA prevalence. Other factors linked to MFA were increased IMT, elevated TCH, decreased BMI, and ICS. 

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The authors declare that there are no conflicts of interest present.