Possibilities of noninvasive diagnostics of cardiovascular diseases associated with atherosclerosis

Abstract

Background. Despite the global trend towards a decrease in mortality from cardiovascular pathology of atherosclerotic genesis, this group of diseases continues to occupy a leading position in the structure of disability and mortality among the population of many countries. Aim. Identification of noninvasive markers of arterial wall lesions associated with the presence of arterial hypertension (AH) and coronary heart disease (CHD) in persons younger than 55 years. Materials and methods. The study included 81 people. Three groups were distinguished from them: 1st (n=31) – a control group of practically healthy individuals, average age – 43 (40; 48) years; 2nd group (n=21) – patients with coronary heart disease without a history of cardiovascular diseases (CVD), average age – 45,5±6,1; group 3 (n=29) – patients with AH without CHD, average age – 47 (35; 50) years. The parameters of a biochemical blood test were determined, volumetric sphygmography and a sample with post-occlusive reactive hyperemia were performed. Results. In groups of patients with CHD and AH, negative changes in the lipid profile and higher glucose levels were recorded compared to healthy individuals. According to the results of volumetric sphygmography, the pulse wave velocity in arteries of predominantly elastic type (R/L-PWV) in group 1 was 10.1±1.7 m/s, in group 2 – 12.9±1.8 m/s, in group 3 – 13.1 (12; 14) m/s (р1–2=0.029; р1–30.001); cardio-ankle vascular index (CAVI) – 6.5±0.7, 7.7 (7; 8.7) and 7.8 (7.3; 8.4), respectively (р1–20.001; р1–30.001). According to the data of the test with post-occlusive reactive hyperemia, a comparably high frequency of pathological values of flow-dependent vasodilation (FDV) and reactivity index (RI) was demonstrated in patients with CHD and AH (р1–20.05; р1–30.05). A multifactorial model of noninvasive diagnosis of CHD in individuals without a history of CVD, including non-high-density lipoprotein cholesterol, R/L-PWV, and FDV, has been developed. For patients with AH, glucose, lipid metabolism, R/L-PWV, pulse wave velocity in muscle-type arteries (B-PWV), augmentation index (AI), biological age, CAVI, FDV, RI were the risk factors for the presence of the disease in the anamnesis. Conclusion. The results obtained confirm the importance of an integrated approach in the screening diagnosis of CVD.

Keywords

• ischemic heart disease
• arterial hypertension
• arterial stiffness
• endothelial function
• lipid profile