cardiovascularКардиоваскулярная терапия и профилактикаCardiovascular Therapy and Prevention1728-88002619-0125«SILICEA-POLIGRAF» LLCcardiovascular-1848Research ArticleИШЕМИЧЕСКАЯ БОЛЕЗНЬ СЕРДЦАCORONARY HEART DISEASEУльтразвуковая оценка атеросклероза сонных артерий и функции эндотелия у мужчин молодого и среднего возраста с ишемической болезнью сердцаUltrasound assessment of carotid artery atherosclerosis and endothelial function in young and middle-aged men with coronary heart diseaseБалахоноваТ. В.BalakhonovaT. V.

Ведущий научный сотрудник отдела новых методов диагностики.

Москва

Moscow

КозловС. Г.KozlovS. G.

Старший научный сотрудник отдела проблем атеросклероза.

Москва

Moscow

МахмудоваХ. А.MakhmudovaKh. A.

Аспирант отдела проблем атеросклероза.

Москва

Moscow

ТрипотеньМ. И.TripotenM. I.

Младший научный сотрудник отдела новых методов диагностики.

Москва

Moscow

ЛякишевА. А.LyakishevA. A.

Ведущий научный сотрудник отдела проблем атеросклероза.

Москва

Moscow

КухарчукВ. В.KukharchukV. V.

Руководитель отдела проблем атеросклероза.

Москва, тел.: (495) 414-68-42

Moscow

v_kukharch@mail.ruИнститут клинической кардиологии им. А.Л.Мясникова, ФГУ РКНПК РосмедтехнологийL.A. Myasnikov Research Institute of Clinical Cardiology, Russian Cardiology Scientific and Clinical Complex200920102009851115Copyright © Балахонова Т.В., Козлов С.Г., Махмудова Х.А., Трипотень М.И., Лякишев А.А., Кухарчук В.В., 20092009Балахонова Т.В., Козлов С.Г., Махмудова Х.А., Трипотень М.И., Лякишев А.А., Кухарчук В.В.Balakhonova T.V., Kozlov S.G., Makhmudova K.A., Tripoten M.I., Lyakishev A.A., Kukharchuk V.V.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/1848Цель

Цель. Ультразвуковая оценка атеросклероза сонных артерий и функции эндотелия у мужчин молодого и среднего возрастов с ишемической болезнью сердца (ИБС).

Материал и методы

Материал и методы. В исследование вошли 78 мужчин в возрасте 28-50 лет, в т.ч. 49 больных ИБС с верифи­цированным посредством ангиографии стенозирующим атеросклерозом коронарных артерий и 29 пациентов — контрольная группа (ГК), без клинических проявлений атеросклероза. Всем пациентам проведено ультразвуковое исследование общих сонных артерий (ОСА) по стандартной методике. Для определения поток-зависимой вазодилатации (ПЗДВ) плечевой артерии выполнена проба с реактивной гиперемией.

Результаты

Результаты. Среди больных ИБС показатель толщины комплекса интима-медиа (КИМ) ОСА составил 0,88±0,23 мм, что было достоверно выше аналогичного показателя у пациентов ГК (0,76±0,18 мм, р=0,01). Атеросклеротические бляшки в ОСА присутствовали у 91,8% больных и 27,6% пациентов из ГК (р<0,001), при этом множественные поражения наблюдались в 80% и 14% случаев, соответственно (р<0,001). ПЗВД плечевой артерии составила в среднем 5,8±2,2%, что было достоверно больше по срав­нению с больными ИБС — 4,5±2,8% (р=0,03).

Заключение

Заключение. Достоверные различия в частоте обнаружения нормальных значений ПЗВД у пациентов обеих групп отсутствовали. Увеличение показателя толщины КИМ и наличие множественных атеро­склеротических бляшек в ОСА у мужчин молодого и среднего возрастов сопряжено с повышенным риском развития ИБС.

Aim

Aim. Ultrasound assessment of carotid artery atherosclerosis and endothelial function in young and middle-aged men with coronary heart disease (CHD).

Material and methods

Material and methods. The study included 78 men aged 28-50 years: 49 CHD patients with angiography-verified coronary artery atherosclerosis and 29 controls (control group, CG), without clinical atherosclerosis manifestations. All participants underwent a standard carotid artery (CA) ultrasound. Brachial artery flow-dependent vasodilatation (FDVD) was assessed in reactive hyperemia test.

Results

Results. Among CHD patients, intima-media thickness (IMT) for common CA (0,88±0,23 mm) was signifi­cantly higher than in CG individuals (0,76±0,18 mm; р=0,01). Atherosclerotic plaques in common CA were observed in 91,8% of the CHD patients and 27,6% of controls (р<0,001). Multiple plaques were observed in 80% and 14%, respectively (р<0,001). Average brachial artery FDVD (5,8±2,2%) was significantly higher than that in CHD patients (4,5±2,8%; р=0,03).

Conclusion

Conclusion. No significant differences in the prevalence of normal FDVD were observed between two groups. Increased IMT and multiple atherosclerotic plaques in common CA were associated with higher CHD risk in young and middle-aged men.

ишемическая болезнь сердцапоток-зависимая вазодилатациятолщина комплекса интима-медиасонные артериимолодой возрастcoronary heart diseaseflow-dependent vasodilatationintima-media thicknesscarotid arteriesyoung ageReferencesBrindle P, Beswick A, Fahey T, Ebrahim S. Accuracy and impact of risk assessment in the primary prevention of cardiovascular disease: a systematic review. Heart 2006; 92: 1752-9.Brindle P, Beswick A, Fahey T, Ebrahim S. Accuracy and impact of risk assessment in the primary prevention of cardiovascular disease: a systematic review. Heart 2006; 92: 1752-9.Kullo IJ, Malik AR. Arterial Ultrasonography and Tonometry as Adjuncts to Cardiovascular Risk Stratification. JACC 2007; 49: 1413-26.Kullo IJ, Malik AR. Arterial Ultrasonography and Tonometry as Adjuncts to Cardiovascular Risk Stratification. JACC 2007; 49: 1413-26.Рогоза А.Н., Балахонова Т.В., Чихладзе Н.М. и др. Современные методы оценки состояния сосудов у больных артериальной гипертонией. Пособие для практикующих врачей. Издательский дом “Атмосфера”. Москва 2008.Рогоза А.Н., Балахонова Т.В., Чихладзе Н.М. и др. Современные методы оценки состояния сосудов у больных артериальной гипертонией. Пособие для практикующих врачей. Издательский дом “Атмосфера”. Москва 2008.Naghavi M, Falk E, Hecht HS, et al. From vulnerable plaque to vulnerable patient — part III: executive summary of the Screening for Heart Attack Prevention and Education (SHAPE) Task Force report. Am J Cardiol 2006; 98: 2H-15.Naghavi M, Falk E, Hecht HS, et al. From vulnerable plaque to vulnerable patient — part III: executive summary of the Screening for Heart Attack Prevention and Education (SHAPE) Task Force report. Am J Cardiol 2006; 98: 2H-15.Anderson TJ. Assessment and treatment of endothelial dysfunction in humans. JACC 1999; 34: 631-8.Anderson TJ. Assessment and treatment of endothelial dysfunction in humans. JACC 1999; 34: 631-8.Lerman A, Zeiher AM. Endothelial function: cardiac events. Circulation 2005; 111: 363-8.Lerman A, Zeiher AM. Endothelial function: cardiac events. Circulation 2005; 111: 363-8.Lieberman EH, Gerhard MD, Uehata A, et al. Flow-induced vasodilation of the human brachial artery is impaired in patients <40 years of age with coronary artery disease. Am J Cardiol 1996; 78: 1210-4.Lieberman EH, Gerhard MD, Uehata A, et al. Flow-induced vasodilation of the human brachial artery is impaired in patients <40 years of age with coronary artery disease. Am J Cardiol 1996; 78: 1210-4.Neunteufl T, Katzenschlager R, Hassan A, et al. Systemic endothelial dysfunction is related to the extent and severity of coronary artery disease. Atherosclerosis 1997; 129: 111-8.Neunteufl T, Katzenschlager R, Hassan A, et al. Systemic endothelial dysfunction is related to the extent and severity of coronary artery disease. Atherosclerosis 1997; 129: 111-8.Furumoto T, Fujii S, Saito N, et al. Relationships between brachial artery flow mediated dilation and carotid artery intima-media thickness in patients with suspected coronary artery disease. Jpn Heart J 2002; 43: 117-25.Furumoto T, Fujii S, Saito N, et al. Relationships between brachial artery flow mediated dilation and carotid artery intima-media thickness in patients with suspected coronary artery disease. Jpn Heart J 2002; 43: 117-25.Frick M, Suessenbacher A, Alber HF, et al. Prognostic value of brachial artery endothelial function and wall thickness JACC 2005; 46: 1006-10.Frick M, Suessenbacher A, Alber HF, et al. Prognostic value of brachial artery endothelial function and wall thickness JACC 2005; 46: 1006-10.Kafetzakis A, Kochiadakis G, Laliotis A, et al. Association of Subclinical Wall Changes of Carotid, Femoral, and Popliteal Arteries With Obstructive Coronary Artery Disease in Patients Undergoing Coronary Angiography. Chest 2005; 128: 2538-43.Kafetzakis A, Kochiadakis G, Laliotis A, et al. Association of Subclinical Wall Changes of Carotid, Femoral, and Popliteal Arteries With Obstructive Coronary Artery Disease in Patients Undergoing Coronary Angiography. Chest 2005; 128: 2538-43.Rohani M, Jogestrand T, Ekberg M, et al. Interrelation between the extent of atherosclerosis in the thoracic aorta, carotid intima-media thickness and the extent of coronary artery disease. Atherosclerosis 2005; 179: 311-6.Rohani M, Jogestrand T, Ekberg M, et al. Interrelation between the extent of atherosclerosis in the thoracic aorta, carotid intima-media thickness and the extent of coronary artery disease. Atherosclerosis 2005; 179: 311-6.Holaj R, Spacil J, Petrasek J, et al. Intima-media thickness of the common carotid artery is the significant predictor of angiographically proven coronary artery disease. Can J Cardiol 2003; 19: 670-6.Holaj R, Spacil J, Petrasek J, et al. Intima-media thickness of the common carotid artery is the significant predictor of angiographically proven coronary artery disease. Can J Cardiol 2003; 19: 670-6.Sakaguchi M, Kitagawa K, Nagai Y, et al. Equivalence of plaque score and intima-media thickness of carotid ultrasonography for predicting severe coronary artery lesion. Ultrasound Med Biol 2003; 29: 367-71.Sakaguchi M, Kitagawa K, Nagai Y, et al. Equivalence of plaque score and intima-media thickness of carotid ultrasonography for predicting severe coronary artery lesion. Ultrasound Med Biol 2003; 29: 367-71.Balbarini A, Buttitta F, Limbruno U, et al. Usefulness of carotid intima-media thickness measurement and peripheral B-mode ultrasound scan in the clinical screening of patients with coronary artery disease. Angiology 2000; 51: 269-79.Balbarini A, Buttitta F, Limbruno U, et al. Usefulness of carotid intima-media thickness measurement and peripheral B-mode ultrasound scan in the clinical screening of patients with coronary artery disease. Angiology 2000; 51: 269-79.Lekakis JP, Papamichael CM, Cimponeriu AT, et al. Atherosclerotic changes of extracoronary arteries are associated with the extent of coronary atherosclerosis. Am J Cardiol 2000; 85: 949-52.Lekakis JP, Papamichael CM, Cimponeriu AT, et al. Atherosclerotic changes of extracoronary arteries are associated with the extent of coronary atherosclerosis. Am J Cardiol 2000; 85: 949-52.Holaj R, Spacil J, Petrasek J, et al. Intima-media thickness of the common carotid artery is the significant predictor of angiographically proven coronary artery disease. Can J Cardiol 2003; 19: 670-6.Holaj R, Spacil J, Petrasek J, et al. Intima-media thickness of the common carotid artery is the significant predictor of angiographically proven coronary artery disease. Can J Cardiol 2003; 19: 670-6.Bots ML, Baldassarre D, Simon A, et al. Carotid intima-media thickness and coronary atherosclerosis: weak or strong relations? Eur Heart J 2007; 28: 398-406.Bots ML, Baldassarre D, Simon A, et al. Carotid intima-media thickness and coronary atherosclerosis: weak or strong relations? Eur Heart J 2007; 28: 398-406.Chambless LE, Heiss G, Folsom AR, et al. Association of coronary heart disease incidence with carotid arterial wall thickness and major risk factors: the Atherosclerosis Risk in Communities (ARIC) Study, 1987-1993. Am J Epidemiol 1997; 146: 483-94.Chambless LE, Heiss G, Folsom AR, et al. Association of coronary heart disease incidence with carotid arterial wall thickness and major risk factors: the Atherosclerosis Risk in Communities (ARIC) Study, 1987-1993. Am J Epidemiol 1997; 146: 483-94.Iglesias del Sol A, Bots ML, Grobbee DE, et al. Carotid intima- media thickness at different sites: relation to incident myocardial infarction; the Rotterdam Study Eur Heart J 2002; 23: 934-40.Iglesias del Sol A, Bots ML, Grobbee DE, et al. Carotid intima- media thickness at different sites: relation to incident myocardial infarction; the Rotterdam Study Eur Heart J 2002; 23: 934-40.O’Leary DH, Polak JF, Kronmal RA, et al. Carotid-artery intima and media thickness as a risk factor for myocardial infarction and stroke in older adults N Engl J Med 1999; 340: 14-22.O’Leary DH, Polak JF, Kronmal RA, et al. Carotid-artery intima and media thickness as a risk factor for myocardial infarction and stroke in older adults N Engl J Med 1999; 340: 14-22.Lorenz MW, von Kegler S, Steinmetz H, et al. Carotid intima-media thickening indicates a higher vascular risk across a wide age range: prospective data from the Carotid Atherosclerosis Progression Study (CAPS). Stroke 2006; 37: 87-92.Lorenz MW, von Kegler S, Steinmetz H, et al. Carotid intima-media thickening indicates a higher vascular risk across a wide age range: prospective data from the Carotid Atherosclerosis Progression Study (CAPS). Stroke 2006; 37: 87-92.Held C, Hjemdahl P, Eriksson SV, et al. Prognostic implications of intima-media thickness and plaques in the carotid and femoral arteries in patients with stable angina pectoris. Eur Heart J 2001; 22: 62-72.Held C, Hjemdahl P, Eriksson SV, et al. Prognostic implications of intima-media thickness and plaques in the carotid and femoral arteries in patients with stable angina pectoris. Eur Heart J 2001; 22: 62-72.Belcaro G, Nicolaides AN, Ramaswami G, et al. Carotid and femoral ultrasound morphology screening and cardiovascular events in low risk subjects: a 10-year follow-up study (the CAFES- CAVE study) Atherosclerosis 2001; 156: 379-87.Belcaro G, Nicolaides AN, Ramaswami G, et al. Carotid and femoral ultrasound morphology screening and cardiovascular events in low risk subjects: a 10-year follow-up study (the CAFES- CAVE study) Atherosclerosis 2001; 156: 379-87.Touboul PJ, Labreuche J, Vicaut E, Amarenco P. Carotid intima-media thickness, plaques, and Framingham Risk Score as independent determinants of stroke risk Stroke 2005; 36: 1741-5.Touboul PJ, Labreuche J, Vicaut E, Amarenco P. Carotid intima-media thickness, plaques, and Framingham Risk Score as independent determinants of stroke risk Stroke 2005; 36: 1741-5.

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