Атеросклероз (Mar 2017)
CLINICO-FUNCTIONAL AND BIOCHEMICAL CHARACTERISTICS OF PATIENTS WITH DIFFERENT ULTRASOUND PHENOTYPES OF CAROTID ATHEROSCLEROSIS
Abstract
Aim: to investigate clinical, functional and biochemical characteristics of patients with different ultrasound patterns of carotid atherosclerosis. Material and methods. The study included 96 hypertensive patients with carotid atherosclerosis, 55 men and 41 women (mean age 60.3±9.31 years). The first group involved 71 patients with plaque in the carotid arteries and IMT greater than 0.9 mm, the second - 25 patients with plaque and IMT less than 0.9 mm. Evaluation of cognitive impairment was performed using a Mini-Mental State Examination (MMSE). We evaluated lipid panel, markers of subclinical inflammation: high-sensitivity C-reactive protein (hs-CRP), IL-1β, IL-6, IL-8, IL-10, TNF-α. Weperformed the probe with endothelium-dependent vasodilation by D.S. Celermajer and duplex scanning of the carotid arteries and lower limb arteries. Results. Among the first group of patients was significantly greater proportion of patients with diabetes mellitus (DM) type 2 and they had significantly higher body mass index (BMI). Also in the first group was significantly lower MMSE score (p = 0,02) and was significantly higher the part of patients with mild cognitive impairment (p = 0.01). IMT values in the femoral arteries were significantly higher in the first group. Patients of the first group had significantly higher values of atherogenic lipoproteins. Patients of the first group had a significantly lower response to dilatation of the brachial artery and was significantly greater the part of patients with endothelial dysfunction - 42 (59 %) versus 11 (44 %) (p = 0.02). In patients with plaque in the carotid arteries and normal IMT revealed significantly higher levels of IL-1β and IL-6. Conclusion. Patients with plaque in the carotid arteries combined with an increase in IMT were significantly higher cholesterol levels of atherogenic lipoprotein fractions, higher BMI and a greater frequency of endothelial dysfunction. In this subpopulation of patients had more severe cognitive impairment. Patients of the second group had significantly lower values of IMT in lower limb arteries and significantly greater levels of circulating IL-1β and IL-6.
