ЦЕРЕБРОВАСКУЛЯРНАЯ ПАТОЛОГИЯ У ПАЦИЕНТОВ C ИШЕМИЧЕСКОЙ БОЛЕЗНЬЮ СЕРДЦА (РЕЗУЛЬТАТЫ НЕЙРОВИЗУАЛИЗАЦИИ)

Abstract

Introduction. Cerebral microangiopathy associated with vascular risk factors makes a significant contribution to the deterioration of the morphological state of the brain. The aim of the study was to assess the neurological status and state of the brain in patients with stable coronary heart disease (CHD) who are treated in the cardiology department before coronary bypass surgery. Material and methods. 170 male patients, aged 58±6 years, were examined. Patients with a history of acute cerebrovascular accident, trauma and brain masses, carotid artery stenosis >50%, depression and dementia were not included. All of them underwent a neurological examination and testing according to the Mini Mental Status Assessment Scale (MSSS). The brain examination was performed on a multislice computed tomography (MSCT) Somatom Sensation 64, Siemens. In describing the results, the following were taken into account: the width of the ventricles of the brain (the age norm of the width of the third ventricle is <7 mm for persons under 60 years of age, and <9 mm - over 60 years of age), leukoaraiosis, cysts, signs of cortical atrophy, the ventriculocranial index 3 (VKI 3) was calculated - the ratio of the maximum width of the third ventricle to the greatest distance between the internal plates of the skull bones (age norms: persons 41-60 years old - 3.3%; 61-70 years old - 3.9%; over 70 years old - 4.3%). Standard methods of descriptive statistics were used. Results. After a neurological examination, it was found that the frequency of occurrence of vestibulopathy syndrome was 24%, asthenic syndrome - 56%, mild cognitive impairment syndrome - 46% (test results for KShOPS - 27 [26; 28] points). The identified neurological symptoms were accompanied by morphological changes in the brain tissues. The width of the third ventricle was 7.6 ± 2.0 mm, the IHF index was 3 - 4.2%, the number of patients with leukoaraiosis was 26%, with signs of cortical atrophy - 19% of patients. When comparing the obtained results of neuroimaging with the established age norms, it was found that, despite the fact that the average age of our patients did not exceed 60 years, the width of the third ventricle in them corresponded to the indicators of the age category of healthy people over 60 years old, and the values of the VKI 3 index corresponded to the age norms. for healthy subjects over 70 years of age. Conclusion. The data obtained indicate that asthenia, moderate cognitive disorders, disorders of the coordinating-motor sphere are very common in patients with coronary artery disease. Neuroimaging signs of cerebral microangiopathy (leukoareosis, expansion of cerebrospinal fluid spaces) indicate the vascular nature of the identified neurological disorders. Issues of progression of cerebrovascular pathology in this cohort of patients require further study.