cardiovascularКардиоваскулярная терапия и профилактикаCardiovascular Therapy and Prevention1728-88002619-0125«SILICEA-POLIGRAF» LLC10.15829/1728-8800-2022-3038cardiovascular-3038Research ArticleСЕРДЕЧНО-СОСУДИСТЫЙ РИСКCARDIOVASCULAR RISK FACTORSЗначение дуплексного сканирования сонных артерий и артерий нижних конечностей в рестратификации кардиоваскулярного риска и инициации гиполипидемической терапииValue of duplex ultrasound of carotid and lower extremity arteries in the restratification of cardiovascular risk and initiation of lipid-lowering therapyhttps://orcid.org/0000-0001-5902-3803ГенкельВ. В.GenkelV. V.

Генкель Вадим Викторович  — кандидат медицинских наук, доцент кафедры пропедевтики внутренних болезней

Челябинск

SPIN-код: 2519-6100

 

Genkel Vadim V. — PhD, assistant of the Department of Propaedeutics of Internal Medicine

Chelyabinsk

henkel-07@mail.ruhttps://orcid.org/0000-0002-0357-5702КузнецоваА. С.KuznetsovaA. S.

Кузнецова Анна Сергеевна  — кандидат медицинских наук, доцент кафедры госпитальной терапии

Челябинск

SPIN-код: 8397-0087

Kuznetsova Alla S. — РhD, assistant of the Department of Clinical Therapy

Chelyabinsk

kuzja321@mail.ruhttps://orcid.org/0000-0003-0658-7626ПыховаЛ. Р.PykhovaL. R.

Пыхова Любовь Романовна  — младший научный сотрудник центральной научно-исследовательской лаборатории, ассистент кафедры микробиологии, вирусологии, иммунологии и  КЛД

Челябинск

SPIN-код: 3226-6247

Pykhova Lyubov R. — junior researcher at the central research laboratory 

Chelyabinsk

lyubov_pykhova@mail.ruhttps://orcid.org/0000-0002-7954-2990ЛебедевЕ. В.LebedevE. V.

Лебедев Евгений Владимирович  — кандидат медицинских наук, доцент кафедры пропедевтики внутренних болезней

Челябинск

SPIN-код: 8194-3251

Lebedev Evgeny V. — РhD, assistant of the Department of Propaedeutics of Internal Medicine

Chelyabinsk

evgueni.lebedev@mail.ruhttps://orcid.org/0000-0003-3962-3662СалашенкоА. О.SalashenkoA. O.

Салашенко Алексей Олегович  — кандидат медицинских наук, доцент кафедры пропедевтики внутренних болезней

Челябинск

SPIN-код: 9154-5703

Salashenko Alexei O. — РhD, assistant of the Department of Propaedeutics of Internal Medicine

Chelyabinsk

salachenko@hotmail.comhttps://orcid.org/0000-0002-7731-7730ШапошникИ. И.ShaposhnikI. I.

Шапошник Игорь Иосифович — доктор медицинских наук, профессор, зав. кафедрой пропедевтики внутренних болезней

Челябинск

SPIN-код: 3184-5994

Shaposhnik Igor I. — MD, PhD, professor, head of the Department of Propaedeutics of Internal Medicine

Chelyabinsk

shaposhnik@yandex.ruФГБОУ ВО “Южно-Уральский государственный медицинский университет” Минздрава РоссииSouth Ural State Medical University20221711202121230383038Copyright © Генкель В.В., Кузнецова А.С., Пыхова Л.Р., Лебедев Е.В., Салашенко А.О., Шапошник И.И., 20222022Генкель В.В., Кузнецова А.С., Пыхова Л.Р., Лебедев Е.В., Салашенко А.О., Шапошник И.И.Genkel V.V., Kuznetsova A.S., Pykhova L.R., Lebedev E.V., Salashenko A.O., Shaposhnik I.I.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/3038Цель

Цель. Изучить роль дуплексного сканирования (ДС) сонных артерий и  артерий нижних конечностей в  рестратификации кардиоваскулярного риска (КВР) и изменении показаний к назначению гиполипидемической терапии.

Материал и  методы

Материал и  методы. В  исследование включен 291 пациент без установленных атеросклеротических сердечно-сосудистых заболеваний в возрасте 40-64 лет. Всем пациентами проводили ДС артерий каротидного бассейна и артерий нижних конечностей (АНК).

Результаты

Результаты. ДС сонных артерий позволило рестратифицировать 140 (65,7%) пациентов низкого/среднего КВР (из 213) в  категорию высокого/очень высокого КВР. Использование ДС АНК привело к рестратификации 101 (47,4%) пациента низкого/среднего КВР (из 213) в  категорию высокого/очень высокого КВР. Применение мультифокального ультразвукового подхода продемонстрировало наибольшую мощность в качестве реклассификатора КВР и позволило отнести 161 (75,6%) пациента (из 213) в группу пациентов высокого и очень высокого КВР. Применение ДС периферических артерий привело к увеличению количества пациентов высокого риска в 2,33-3,02 раза. Доля лиц, имеющих показания к немедленному началу гиполипидемической терапии увеличилась с  50 (21,0%) пациентов до 170 (71,4%).

Заключение

Заключение. У  пациентов 40-64 лет без установленных атеросклеротических сердечно-сосудистых заболеваний применение ДС сонных артерий и  АНК позволило отнести 75,6% пациентов низкого/среднего КВР в  группу пациентов высокого и  очень высокого КВР. По результатам реклассификации КВР доля пациентов, имеющих показания к немедленному началу гиполипидемической терапии, увеличилась с 21,0 до 71,4% пациентов.

 

 

Aim

Aim. To study the role of duplex ultrasound (DU) of carotid and lower extremity arteries in the restratification of cardiovascular risk (CVR) and changing the indications for lipid-lowering therapy.

Material and methods

Material and methods. The study included 291 patients aged 40-64 years without established atherosclerotic cardiovascular diseases. All patients underwent DU of carotid and.

Results

Results. Carotid DU make it possible to restratify 140 (65,7%) patients with low/moderate CVR (out of 213) into the category of high/very high CVR. Lower extremity artery DU resulted in the restratification of 101 (47,4%) patients with low/moderate CVR (out of 213) into the category of high/very high CVR. The use of a multifocal ultrasound technique demonstrated the highest restratification power and allowed 161 (75,6%) patients (out of 213) to be assigned to the high/very high CVR group. The use of peripheral arterial DU led to an increase in the number of high-risk patients by 2,33-3,02 times. The proportion of persons with indications for lipid-lowering therapy increased from 50 (21,0%) patients to 170 (71,4%).

Conclusion

Conclusion. In patients aged 40-64 years without established atherosclerotic cardiovascular diseases, the use of DU of carotid and lower extremity arteries made it possible to classify 75,6% of patients with low/moderate CVR in the group of patients with high and very high CVR. According to CVR reclassification, the proportion of patients with indications for lipid-lowering therapy increased from 21,0 to 71,4% of patients.

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