cardiovascularКардиоваскулярная терапия и профилактикаCardiovascular Therapy and Prevention1728-88002619-0125«SILICEA-POLIGRAF» LLC10.15829/1728-8800-2014-3-41-46cardiovascular-60Research ArticleИШЕМИЧЕСКАЯ БОЛЕЗНЬ СЕРДЦАCORONARY HEART DISEASEВЛИЯНИЕ ОЛМЕСАРТАНА НА ЛОКАЛЬНУЮ И РЕГИОНАЛЬНУЮ РИГИДНОСТЬ АРТЕРИЙ У БОЛЬНЫХ ИШЕМИЧЕСКОЙ БОЛЕЗНЬЮ СЕРДЦАEFFECTS OF OLMESARTAN ON LOCAL AND REGIONAL RIGIDITY OF ARTERIES IN ISCHEMIC HEART DISEASEМатросоваИ. Б.MatrosovaI. B.

к. м.н., доцент кафедры “Терапия”

oleynikoff@sura.ruМельниковаЕ. А.MelnikovaE. A.

ассистент кафедры “Терапия”

oleynikoff@sura.ruОлейниковВ. Э.OleynikovV. E.

д. м.н., профессор, зав. кафедрой “Терапия”

oleynikoff@sura.ruМедицинский институт ФГБОУ ВПО Пензенский государственный университет, ПензаMedical Institution FSBEI HPE Penza State University. Penza, Russia2014200620141334146Copyright © Матросова И.Б., Мельникова Е.А., Олейников В.Э., 20142014Матросова И.Б., Мельникова Е.А., Олейников В.Э.Matrosova I.B., Melnikova E.A., Oleynikov V.E.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/60Цель

Цель. Оценить влияние 24-недельной терапии олмесартаном на жесткость артерий в различных сосудистых бассейнах у больных ишемической болезнью сердца (ИБС) в сочетании с артериальной гипертонией (АГ) 1–2 степени.

Материал и методы

Материал и методы. В открытое, нерандомизированное исследование включены 25 больных ИБС в сочетании с АГ 1–2 степеней. Пациенты на протяжении 24 нед. получали олмесартана медоксомил в дозе 20–40 мг/сут. Исходно и через 6 мес. оценивали жесткость сонных артерий ультразвуковым методом с применением технологии echotracking, определяли толщину комплекса интимамедиа (ТКИМ). Для изучения региональной жесткости сосудов использовали метод объемной сфигмографии.

Результаты

Результаты. Согласно данным объемной сфигмографии, терапия олмесартаном сопровождалась достоверным снижением PWVао на 19,4%, R-PWV и L-PWV — на 11,9% и 11,6% (p<0,05). CAVI1 уменьшился на 9,3%, L–CAVI1 — на 13,7%, CAVI2 — на 14,9% (p<0,05). В-PWV достоверно не менялась. На фоне 24-недельной фармакотерапии отмечен регресс каротидного атеросклероза: снижение ТКИМ с 773,6±155,7 μм до 736,3±124,1 μм (p<0,05). Наблюдали достоверное уменьшение loc P sys и loc P dia на 13,5% и 11% (p<0,05); снижение индекса жесткости β на 19,1% (p<0,05). Отмечено увеличение коэффициента поперечной податливости на 3,3% (p<0,05) и снижение loc PWV на 17% (p<0,05). Коэффициент поперечной растяжимости, locAix и ДОСА достоверно не менялись.

Заключение

Заключение. Добавление олмесартана к стандартной терапии ИБС и АГ сопровождалось достоверным улучшением характеристик локальной и региональной жесткости.

Aim

Aim. To evaluate 24-week treatment by olmesartan on rigidity of arteries in different vessel areas in patients with coronary heart disease (CHD) with 1–2 grade arterial hypertension (AH).

Material and methods

Material and methods. Into open-label, non-randomized trial 25 patients with CHD and 1–2 grade AH were included. During 24-week treatment period patients received olmesartan medoxomil 20–40 mg daily. Baseline and final parameters of arterial wall stiffness were measured using ultrasound method with echotracking. The thickness of intima-media (TIMC) was defined. To evaluate regional vessel stiffness the volume sphygmography method was used.

Results

Results. Acorrding to the data of volume sphygmography terapy by olmesartan significantly decrease PWVao by 19,4%, R-PWV b L-PWV — by 11,9% and 11,6% (p<0,05). CAVI1 decreased by 9,3%; L–CAVI1 — by 13,7%, CAVI2 — на 14,9% (p<0,05). В-PWV did not change significantly. During 24-week medication treatment the regress of carotid atherosclerosis was marked: decrease of TIMC from 773,6±155,7 μm to 736,3±124,1 μm (p<0,05). The values loc P sys and loc P dia significantly decreased by 13,5% and 11% (p<0,05); rigidity index β by 19,1% (p<0,05). Also we marked the increase of transverse pliability by 3,3% (p<0,05) and decrease of loc PWV by 17% (p<0,05). The coefficient of transverse pliability, locAix and DOCA did not show significant changes.

Conclusion

Conclusion. Addition of olmesartan to the standard treatment of CHD and AH showed significant improvement of local and regional stiffness.

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