Zaporožskij Medicinskij Žurnal (Oct 2017)
Features of vascular remodelling in the patients with arterial hypertension in a case of brain stroke
Abstract
Purpose of research – to determine the features and factors which influence the vascular remodelling in patients with arterial hypertension in the late restoration period of brain stroke, taking into account an intima-media complex thickness. Materials and methods. The research enrolled 44 patients with stage III AH in the restoration period of a brain stroke. All participants underwent ultrasound examination of the brachycephalus arteries, daily monitoring of arterial pressure, Doppler echocardiography. Patients were divided into 2 groups: the I group included 24 patients (54.5 %) with normal thickness of complex intima-media (CIM), the II group – 20 (45.5 %) patients with thickness of CIM >0.9 mm. Results. In the patients with stage III AH in a case of brain stroke thickening of CIM was in 45.5 %, concentric hypertrophy – in 25.0 % and remodelling – in 10.0 %. Daily profiles of AP such as night-peaker were observed in 20.0 % of patients, an over-dipper – in 5.0 %, which indicated an unfavourable prognosis regarding repeated cases of the cardiovascular events. Structural and functional features in the vessels of patients with stage III AH were formed under an influence of both diastolic and systolic dysfunction of LV, hypertrophy and concentric remodelling, presence, duration and an inadequate treatment of AH, anthropometric and other risk factors in the patients with AH in the restoration period of a brain stroke, which requires a rigorous tactic of their correction. Conclusions. Determination of the factors affecting structural and functional peculiarities of vessels in the patients with AH, together with commonly accepted risk factors, should be on a basis to assess their rehabilitation potential, stratification of a common cardiovascular risk, development of an individual rehabilitation program for disabled people with this pathology. Further, the role, character, prognosis and effectiveness of the revealed features correction in the patients with arterial hypertension in the restoration period of a brain stroke should be clarified.
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