Duplex Scanning Of Arteries Research Articles

Instrumental diagnosis of cognitive impairment in workers engaged in the maintenance of agricultural machinery

Workers engaged in the maintenance of agricultural machinery are exposed to a number of production factors in the course of their work, which can be considered as risk factors for the development of cognitive impairment. The purpose of the work: to diagnose cognitive disorders using informative instrumental methods of examination of mental functions, such as cognitive evoked potentials P 300, ultrasound duplex scanning of brachiocephalic arteries in combination with the determination of the atherogenicity index. In order to diagnose the stages of cognitive impairment early, optimal quantitative and qualitative signs in combination with professional experience and age have been determined. Each feature was evaluated in points, which are further summarized. The stages of cognitive impairment are determined by the sum of the points.

Examination of patients with diabetes mellitus and peripheral arterial disease according to the adapted ischaemic criteria of the WIfI classification

Objective. To combine the determination of ischemia class indicators according to the WIfI classification and simultaneous performance of ultrasound duplex scanning of the arteries of both lower extremities during the initial examination of patients with diabetes mellitus and peripheral arterial disease to predict healing, determine the risk of amputation and the need for revascularisation. Materials and methods. We treated 74 patients with diabetes mellitus and peripheral arterial disease who had signs of infection, ulceration or destruction of deep foot tissues. Patients were divided into two groups: the main group – 43 patients (ischaemia class was determined by the WIfI classification with simultaneous performance of ultrasound duplex scanning of the lower extremity arteries with assessment of lesions by ultrasound criteria) and the control group – 31 patients (ischaemia class according to the WIfI classification was determined only by portable Doppler). Patients in both groups received comprehensive treatment. Results. During the 1–year follow–up, the frequency of re–hospitalisation associated with deterioration of the condition due to limb ischaemia in the main group was statistically significantly (p=0.03) lower than in the control group. Conclusions. The integration of ultrasound duplex scanning at the initial stage of diagnosis allows to determine the degree of ischemia more accurately and to refer the patient for vascular correction in time.

Ultrasound criteria for assessing the correction of metabolic-associated fatty liver disease and liver blood flow disorders using arginine in patients with coronary artery disease in combination with COVID-19

Background. Coronavirus disease 2019 (COVID-19) remains one of the most urgent global health problems today. In the conditions of its spread around the world, the global scientific community is trying to study not only respiratory, but also extrapulmonary manifestations of this infection. It is known that with COVID-19, the endothelium, the hemostasis system, and the liver are affected with the occurrence of such a complication as metabolic dysfunction-associated steatotic liver disease (MASLD). The most vulnerable group of patients in terms of coronavirus disease and its complications (including MASLD) are those with coronary heart disease (CAD), therefore the search for effective drugs and optimal ultrasound criteria to evaluate liver steatosis in the dynamics of treatment is the main task of modern medicine. Goal: to determine the ultrasound criteria for assessing the correction of MASLD and liver blood flow disorders using arginine in patients with CAD associated with COVID-19. Materials and methods. A prospective study was conducted in 52 patients with CAD combined with PCR-positive COVID-19. The study was carried out upon admission to the hospital and 6 months after discharge. Group I (n = 27) consisted of CAD + COVID-19 patients who, in addition to standard therapy for MASLD, received arginine for 6 months after discharge from the hospital; group II (comparison group, n = 25) included participants who received standard therapy wi­thout arginine. Results. Splanchnic artery duplex scanning at baseline showed that 21 (78.0 %) patients in group I and 19 (76.0 %) in group II had a decrease in peak systolic velocity (PSV) in the proper hepatic artery (PHA), an increase in portal vein blood flow at the beginning of treatment, as well as increased liver size in 20 (74.0 %) patients in group I and 17 (68.0 %) in group II. An increase in the attenuation coefficient was detected in all patients of groups I and II. There were no differences between the groups at the time of inclusion in the study in terms of splanchnic blood flow and atte­nuation coefficient. After 6 months of arginine treatment, an improvement in the portal vein blood flow and a decrease in blood flow velocity in the PHA, a decrease in the diameter of the portal vein, a decrease in the size of the right and left liver lobes were found in group I, with no improvement in group II. A repeated study revealed a decrease in the attenuation coefficient in group I and no changes in group II. At the beginning of the study, a direct correlation was found between fibrinogen and the attenuation coefficient in group I (r = 0.54; p < 0.05), as well as in group II (r = 0.51; p < 0.05). After 6 months, C-reactive protein decreased in both groups. Conclusions. In patients with CAD combined with COVID-19 in the presence of MASLD, a decrease in the portal vein blood flow and an increase in PSV in the PHA were found. When arginine was used for 6 months in combination with standard therapy, according to the European Society of Cardiology protocols, there was a significant decrease in the attenuation coefficient, PSV in the PHA, and an increase in the portal vein blood flow. This indicates the possibility of using the attenuation coefficient as the main marker, and PSV in the PHA and the portal vein blood flow as additional criteria for ultrasound assessment of MASLD correction with arginine in patients with CAD combined with COVID-19.

#1411 Intrarenal hemodynamics in patients with coronary heart disease in the post-COVID-19 period

Abstract Background and Aims Coronary heart disease (CHD) and obesity are common pathologies in patients who have had COVID-19. Endothelial dysfunction (ED) markers determination has been important in such patients due to the high risk of cardiovascular diseases progression and complications development. THE AIM Assessment of endothelial dysfunction severity in patients with CHD and obesity in the post-COVID-19 period to improve the management of these patients. Method 49 patients were examined, who had COVID-19 a year ago. The first group (n=24) included patients with coronary artery disease in the post-COVID period. The second group (n=25) included patients with CHD and obesity who had COVID-19. We evaluated data from an ultrasound examination of the kidneys with duplex scanning of the renal arteries (resistance index (RI), pulsation index (PI)). We also studied the medical history, performed an objective examination, the results of a biochemical blood test, albuminuria levels. Results We demonstrated higher RI and PI of interlobar, segmental arteries in persons of the second group. An increase in RI and PI of segmental arteries accompanied by an increase in uric acid (p=0.001). The average level of microalbuminuria in the first group was 15.71 ± 4.51 μg/l, in the second group it was 24.38 ± 5.38 μg/l (p=0.110). Increasing glucose levels accompanied by an elevation of C-reactive protein levels. Obese patients had significantly higher levels of total cholesterol, triglycerides, low density lipoproteins than patients in the first group. Conclusion We observed changes in lipid metabolism, a higher incidence of diabetes mellitus in females, and changes in intrarenal hemodynamic parameters associated with uric acid levels in patients with coronary heart disease and obesity in the post-COVID-19 period.

Echographic pattern features of dissections of the extracranial parts of the brachiocephalic arteries

Purpose: to determine the frequency of various ultrasound signs of dissections of the extracranial parts of the brachiocephalic arteries, as well as to compare the results of ultrasound and neuroimaging methods in the diagnostics of dissections.Materials and methods. The study included data on 108 patients, among them 44 (40.7%) women, 64 (59.3%) men, mean age was 56 ± 14 years. All patients underwent duplex scanning of the brachiocephalic arteries, 53 patients underwent CT-angiography, and 99 patients underwent MRI.Results. The sensitivity of duplex scanning in the primary diagnosis of dissections in our study was 97.2%. In 40 patients (37%) with dissections according to duplex scanning the presence of dissection was also confirmed on CT-angiography or MRI. Expansion of the vessel diameter and the presence of intramural hematoma (IMH), as well as their combination, were the most common ultrasound signs of dissections in our study. In cases where dissection was not confirmed by CT-angiography or MRI data moderate echogenicity of IMH was noted significantly more often (p = 0.018). Of all the ultrasound signs of dissections, the highest share of coincidence with the signs obtained with neuroimaging diagnostic methods occurred with IMG.Conclusion. The most frequently recorded ultrasound signs of dissections were the expansion of the vessel diameter and the presence of IMG, as well as their combination. The results of the study showed a high sensitivity of the ultrasound method in detecting dissections, especially in the subacute and chronic stages, as well as to determine the causes of ischemic stroke in the differential diagnosis of brachiocephalic artery pathologies.

Effect of FEMOKLIM on the state of blood vessels in hypoestrogenemia and arterial hypertension

The article presents the results of duplex scanning of the common carotid arteries (CCA) and assessment of the structural and functional state of the vascular bed of 57 women with arterial hypertension (AH) with hypoestrogenemia. It was found that with hypertension with a reduced level of estradiol, the lumen of the OCA increases, the speed of blood flow in the carotid arteries decreases, which indicates vascular remodeling. In the studied patients, in every third case, an inertial type of vasomotor reaction is detected before treatment, which indicates the contribution of dishormonosis to the progression of hypertension due to the development of endothelial dysfunction. Combined therapy with phytoestrogens and ACE inhibitors improves the structural and functional characteristics of the vascular wall, reduces arterial stiffness. The drug Femoklim is a source of phytohormones, hormones of entomological origin and natural antioxidants, has a positive effect on the state of the vascular system, improves blood microcirculation, is a capillary protector, has a complex harmonizing effect on the body.

The nature of abdominal surgery for polycystic kidney disease in animals and the role of sonographic indicators at different stages of surgical intervention: A literature review

Analysis of the method of using sonography during surgery in animals with polycystic kidney disease is an urgent task since firstly, sonography is a safe and non-invasive method of examination, which allows determining the structural features of the kidneys before, during, and after surgery. Secondly, from the standpoint of improving the results of surgery, sonography helps to clarify the localisation of cysts and determine their size. Thirdly, an important factor in the use of sonography is the reduction of pain and the risk of postoperative complications. In addition, due to this method of kidney examination, it is possible to more accurately determine the optimal route of access to cysts, which helps to reduce tissue injury and ensures rapid recovery of the animal after surgery. The purpose of the study is to analyse in detail and describe the method of using sonography during surgery in animals with polycystic kidney disease. The study focuses on the need to determine how sonography affects reducing the duration of surgery, improving the quality of cyst removal, and reducing the risk of complications during abdominal surgery. The approach in this study is based on the analysis of scientific papers on this subject, in particular on the experience of veterinarians who have already used sonography during abdominal operations in animals with polycystic kidney disease. Thus, special techniques of sonography and surgical treatment of kidney cysts include dopplerography, colour dopplerography, 3D and 4D sonography, elastography, introperative sonography, intraperitoneal sonography, and duplex scanning of renal arteries and veins. Surgical methods of treatment include extraction of individual cysts, drainage of cysts, resection, and nephrectomy. The use of sonography at different stages of surgical intervention helps to optimise the operation process, reduce the risk of complications, and contribute to the introduction of new approaches in the treatment of animals with polycystic kidney disease, which will substantially improve their quality of life

Duplex Scans Performed Immediately Following Lower Extremity Angioplasty and Stenting are of Limited Utility

ObjectiveTogether with clinical examination, surveillance duplex examination represents the SVS recommendations for follow up after endovascular intervention on the SFA and popliteal arterial segments. Compliance with post-procedural follow-up remains challenging. To establish a post-angioplasty physiologic baseline, our institution began obtaining immediate post-procedural surveillance studies following lower extremity arterial interventions. We reviewed the utility of immediate post-procedural surveillance to determine if these studies enhanced post-operative care. MethodsSerial patients undergoing SFA and popliteal angioplasty and stenting from 1/2014 to 12/2020 were identified from our prospectively maintained Vascular Surgery database. Patient demographic information, procedural details, and procedural outcomes were subsequently analyzed from the EMR. ResultsTwo hundred and sixty-three patients underwent 385 SFA and/or popliteal angioplasty/stenting interventions. Mean patient age was 64.8 ±10 years. Among these 385 procedures, 350 (90.9%) were followed by immediate (< 4 hours) post-procedural lower extremity arterial duplex scans. These 350 procedures included PTA and/or stenting of the SFA (n=236), popliteal artery (n=34), or both (n=80). Of these studies, 25 results (7.1%) were abnormal. One asymptomatic patient was admitted to hospital for immediate thrombolysis; however, the remaining 24 patients were followed clinically with no immediate intervention required. Abnormal results included 13 abnormalities appreciated on the final angiogram with 9 patients with known occlusions or stenoses, and 4 patients with mild to moderate CFA stenosis. Abnormal findings not detected on the final angiogram included 7 patients with mild to moderate stenosis and 5 patients with short occlusions (1.4%). All 5 patients with short segmental occlusions not detected on final arteriogram had pre-procedural anatomy classified as either TASC C (n=1) or TASC D (n=4). ConclusionImmediate post-procedural duplex scans demonstrate significant vessel stenosis or occlusion in approximately 7% of cases but most stenoses and occlusions were noted on final arteriography. Duplex detected short segmental occlusions not noted on final arteriography were rare (1.4%), and occurred among patients with TASC-C or -D occlusive disease. These duplex detected abnormalities rarely changed the patient’s immediate plan of care. The performance of these immediate post-procedural duplex scans demonstrated limited clinical utility.

Structural and functional changes in the arteries in young women living in the industrial region of the Far North under the aerogenic impact of chemical technogenic factors

Ambient air pollution is a significant risk factor for cardiovascular diseases.&#x0D; Purpose of the work: to study the structural and functional characteristics of the carotid arteries in women living in the Far North under conditions of exposure to metals and particulate matter.&#x0D; Materials and methods. Observation group consisted of seventy eight women living in the Far North in the zone of impact of metallurgical enterprises; comparison group included 20 women living in similar climatic conditions. Duplex scanning of the brachiocephalic arteries was used to evaluate the intima-media thickness (IMT), Peterson’s (Ep) and Young’s (Ym) elastic modules. The cause-and-effect relationships of vascular disorders with blood concentrations of nickel, copper, and chromium were studied.&#x0D; Results. In the observation group the IMT thickness was greater than in the comparison group (0.55 (0.49;0.62) mm versus 0.46 (0.45;0.5) mm, p &lt; 0.0001). In the observation group, Ep was 1.84 times and Ym was &#x0D; 1.52 times higher than the indicators in the comparison group. The relative risk of increasing IMT reached &#x0D; 2.1 (95% CI 1.1–4.3). An increase in the probability of IMT thickening was revealed with an increase in the blood chromium concentration (R2 = 0.10; p = 0.003), an increase in the values of Ep — copper (R2 = 0.15; &#x0D; p = 0.002) and chromium (R2 = 0.19; p = 0.0002), and Ym values — copper (R2 = 0.39; p &lt; 0.0001).&#x0D; Limitations of the study. This study did not include middle-aged and elderly women, men, and did not include the population of territories other than the Far North.&#x0D; Conclusions. Young women living in conditions of inhalation exposure to nickel, chromium, copper, and particulate matter experience an intensification of atherosclerotic and arteriosclerotic processes, manifested by an increase in IMT, atherosclerotic plaques, and an increase in the stiffness of the common carotid artery (CCA). A cause-and-effect relationship between the copper and chromium blood concentration and the probability of an increase in IMT, Ep and Ym has been established. The identified changes in the CCA make it possible to classify young women living in environmentally unfavourable areas as a higher category of cardiovascular risk.

Features of intrarenal hemodinamics as endotelial dysfunction indicator in patients with coronary heart disease in the post-COVID-19 period

BACKGROUND. Coronary heart disease (CHD) and obesity are common pathologies in patients who have had COVID-19. Endothelial dysfunction (ED) markers determination has been important in such patients due to the high risk of cardiovascular diseases progression and complications development.THE AIM Assessment of endothelial dysfunction severity in patients with CHD and obesity in the post-COVID-19 period to improve the management of these patients.PATIENTS AND METHODS. 49 patients were examined, who had COVID-19 a year ago. The first group (n=24) included patients with coronary artery disease in the post-COVID period. The second group (n=25) included patients with CHD and obesity who had COVID-19. We evaluated data from an ultrasound examination of the kidneys with duplex scanning of the renal arteries (resistance index (RI), pulsation index (PI)). We also studied the medical history, performed an objective examination, the results of a biochemical blood test, albuminuria levels.RESULTS. We demonstrated higher RI and PI of interlobar, segmental arteries in persons of the second group. An increase in RI and PI of segmental arteries accompanied by an increase in uric acid (p=0.001). The average level of microalbuminuria in the first group was 15,71± 4,51 μg/l, in the second group it was 24,38±5,38 μg/l (p=0.110). Increasing glucose levels accompanied by an elevation of C-reactive protein levels. Obesepatients had significantly higher levels of total cholesterol, triglycerides, low density lipoproteins than patients in the first group.CONCLUSION. We observed changes in lipid metabolism, a higher incidence of diabetes mellitus in females, and changes in intrarenal hemodynamic parameters associated with uric acid levels in patients with coronary heart disease and obesity in the post-COVID-19 period.

Retrospective analysis of cases of transient global amnesia admitted to the hospital

Introduction. Transient global amnesia (TGA) is a clinical syndrome, the main clinical manifestation of which is sudden development of anterograde and retrograde amnesia, lasting not more than 24 hours, without other general cerebral or focal neurological symptoms.The aim of the work was to reveal the peculiarities of clinical manifestations and data of additional methods of examination of patients with TGA syndrome referred to the primary vascular department with suspected acute cerebral circulation disorder (ACCD).Materials and methods. The study included 16 patients with transient global amnesia diagnosed according to the diagnostic criteria of Hodges and Warlow (1990). All patients underwent a detailed neurological and general medical examination. Electrocardiography, multispiral computer tomography of the head, echocardiography, ultrasound duplex scanning of the main arteries of the head and neck, laboratory examination (lipid spectrum) were performed. The Brief Mental Status Rating Scale was used to assess cognitive impairment.Results. The majority of patients had elevated blood pressure (BP). The leading trigger factor of transient global amnesia was stress. The duration of amnesia ranged from 1.5 to 5 hours. There was a significant impairment of short-term memory. On the first and second days of hospitalization, 50% of patients had normal cognitive functions on a brief mental status assessment scale, but by the 5th−7th day only 12.5 % of patients had abnormalities. Ultrasound markers of atherosclerosis in the form of intima-media complex thickening and dyslipidemia were found in 6 patients. Signs of left ventricular hypertrophy were found in the majority of patients. Discussion TGA is a relatively rare condition and an understudied syndrome. Due to its suddenness of clinical manifestation, TGA requires differential diagnostics with acute cerebral circulatory disorders, epilepsy, acute hypertensive encephalopathy and psychogenic amnesia.Conclusion. The clinical features of TGA identified in the patients were a history of arterial hypertension, elevated BP during an episode of TGA. The leading provoking factor was stress. TGA episode occurred predominantly in the first half of the day. The majority of patients had complaints of headache on admission. Cognitive disorders detected in patients on the first and second days of the disease quickly regressed to normal. Left ventricular hypertrophy was detected in most patients.

Consensus on renovascular hypertension: diagnosis and treatment

The clinical significance of renovascular arterial hypertension is determined by it is high prevalence as well as it is negative impact on prognosis. The most common causes of renovascular arterial hypertension are atherosclerotic stenosis of the renal arteries and fibromuscular dysplasia. Renovascular arterial hypertension is characterized by the development of blood pressure resistant to antihypertensive therapy with an unfavorable prognosis of worsening renal function and cardiovascular complications. Currently, the most available screening method in the diagnosis of renovascular arterial hypertension is duplex scanning of the renal arteries. Non-invasive diagnostic methods also include magnetic resonance and multispiral computed tomography with intravenous contrast. Contrast angiography remains “the golden standard” for diagnosing renovascular arterial hypertension and determining the indications for surgical treatment. Together with the use of diagnostic techniques such as measurement of translesion pressure gradient and fractional blood flow reserve, it allows to assess the functional significance of renal artery stenosis. Treatment of renovascular arterial hypertension is a complex process aimed at normalization of blood pressure, improvement of renal function, as well as mortality and cardiovascular risk reduction. To date, the feasibility of endovascular treatment remains an open question. More often the preference is given to conservative treatment. The indications for renal artery revascularization are less obvious, available clinical guidelines and results of large trials are controversial.

All That Glitters Is Not Gold

The Fate of Patients Opportunistically Screened for Abdominal Aortic Aneurysms During Echocardiogram or Arterial Duplex ScansEuropean Journal of Vascular and Endovascular SurgeryPreviewTo evaluate the long term outcomes of individuals who attended for transthoracic echocardiograms (TTEs) or lower limb arterial duplex scans (LLADS) and were opportunistically screened for abdominal aortic aneurysms (AAA). Full-Text PDF Open Access

Assessment of Biomarker Profile in Patients Post Carotid Angioplasty and Stenting

Introduction. Cardiovascular diseases are predominantly caused by atherosclerosis as a multifactorial chronic condition. Alterations in the hematological system and the blood vessel wall are considered as highly significant for onset and development of cerebrovascular disorders associated with atherosclerosis. Biomarkers as measurable indicators are to verify abnormal activity.&#x0D; Objective: to assess atherogenesis biomarkers in patients after carotid angioplasty and stenting (CAS) as associated with development of cerebrovascular disease.&#x0D; Materials and methods. We evaluated 50 individuals (50% men, 50% women; average age 65.4 6.4 years) with established cerebrovascular disease associated with brain atherosclerosis. All of them had hemodynamically significant abnormalities in the internal carotid artery (ICA) with both symptomatic (stenosis 60% and more) and asymptomatic (stenosis 70% and more) stenoses confirmed by duplex scanning of the brachiocephalic arteries. All patients underwent CAS as indicated. Before and 1 year after the intervention, we performed clinical and neurological examinations, brain magnetic resonance imaging, and laboratory tests of atherogenesis biomarkers.&#x0D; Results. At baseline, all the individuals demonstrated a pro-atherogenic shift in the assessed indicators, predominantly markers of extracellular matrix degradation, inflammation and atherogenesis (including osteoprotegerin and chromogranin А). Additionally, we established a direct correlation between osteoprotegerin levels and the characteristics of mostly hyperechoic atherosclerotic plaques (r = 0.29; p 0.05). A year later, no signs of restenosis were shown in follow-up ultrasound assessment of stented arteries in any patient.&#x0D; In 1 year post CAS, we found significant changes in the levels of osteoprotegerin (decrease to 1.765 pg/mL [1.592; 1.937]; p 0.05) and chromogranin А (elevation to 31.3 g/L [13.9; 90.7]; p 0.05). Re-assessment demonstrated association between changes in the pattern of the nitrogen oxide system, which tends to improve (NO elevation to 38.23 mol/L [32.95; 43.51]; p 0.001), and atheroprotective shift in the morphology of atherosclerotic plaques and biomarker profile.&#x0D; Conclusion. Prospective, 1-year long observation for patients who underwent CAS for symptomatic/asymptomatic hemodynamically significant ICA stenoses revealed favourable atheroprotective shift in both ultrasound and hematological atherogenesis biomarker ratio. This shift contributed to the absence of cerebral atherosclerosis progression during the follow-up. The process may be mediated by chromogranin А and osteoprotegerin, and their further research is needed from perspective of atherogenesis.

The Fate of Patients Opportunistically Screened for Abdominal Aortic Aneurysms During Echocardiogram or Arterial Duplex Scans

To evaluate the long term outcomes of individuals who attended for transthoracic echocardiograms (TTEs) or lower limb arterial duplex scans (LLADS) and were opportunistically screened for abdominal aortic aneurysms (AAA). Follow up of a prospective single centre pilot cohort study conducted between December 2012 and September 2014 at a tertiary vascular centre in the United Kingdom. Men and Women aged 65 and over were invited to undergo AAA screening when attending hospital for TTE or LLADS. Screening was performed by ultrasonographic examination of the abdomen at the end of their planned scans. AAA was defined as an abdominal aorta outer wall to outer wall anteroposterior diameter of 30 mm or more. Patients were excluded if they had a known AAA or previous abdominal aorta intervention. Follow up outcomes were evaluated in December 2020. 762 patients were enrolled in this study; 486 had TTE and 276 patients had LLADS. The overall incidence of AAA was 54 (7.1%) in the combined cohort, 25 (5.1%) in the TTE group, and 29 (10.5%) in the LLADS group. After a median 7.6 years, two of the 54 AAAs received intervention in the form of endovascular repair. Three others reached treatment threshold but were managed conservatively. The overall intervention rate was 3.7% of detected AAAs. Adjusted mortality rates in those with AAA vs. without was 64.8% and 36%, respectively (hazard ratio [HR] 2.02, p < .001). Diabetes (HR 1.35, p= .015) and older age (HR 1.18, p= .17) were the other factors associated with death. AAA is associated with a significantly increased mortality rate. Populations attending hospital for TTE or LLADS demonstrate a higher prevalence of AAA than population based screening; however, the proportion offered AAA intervention was low. Further research into opportunistic screening should target those more likely to undergo AAA repair, unless other interventions are demonstrated, to reduce the general increased mortality in AAA patients.

Modern organization aspects of the prevention of ischemic stroke in patients with extracranial carotid stenosis

Stroke is the second leading cause of death and the third leading cause of disability globally. This literature review described risk factors and diagnostic aspects of ischemic stroke prevention. Carotid stenosis and occlusion is a treatable cause of ischemic stroke, which can be diagnosed by duplex scanning of the brachiocephalic arteries. The reasons for the low effectiveness of preventive measures for ischemic stroke are the incomplete collection of anamnesis for risk factors that affect the clinical prognosis, the low use of modern diagnostic methods by primary health care general practitioners in the screening of patients.

RELATION OF METABOLIC PROFILE WITH DIFFERENT TYPES OF CAROTID LESIONS IN HYPERTENSIVE PATIENTS

Objective: The aim of our study was to identify the relations of lipid profile and uric acid (UA) with the types of carotid artery lesions (CL) in hypertensive patients. Design and method: 67 hypertensive patients (35 men and 32 women) were examined (median age 51[45;55], hypertension duration was 3[2;5]). The subjects underwent duplex scanning of the carotid arteries (Samsung HS50, 2021). Metabolic profile included total cholesterol(TC), low density lipoproteins(LDL), high density lipoproteins(HDL), triglycerides(TG), and uric acid(UA). The results of the study were processed by the program Statistica 10.0. Results: All patients were divided into 4 groups according to on the type of CL: group 1 (n = 39) without pathological carotid tortuosity(PCAT) and atherosclerotic plaques(AP); group 2 (n = 11) with PCAT, but without AP; group 3 (n = 11) with AP&lt;70% stenosis and without PCAT, and group 4 (n = 6), with both PCAT and AP&lt;70% stenosis. The groups did not differ significantly in gender and age (p&gt;0.05). Group 1 had TC level of 5.1[4.5;6.4]mmol/L, LDL of 2.3[2.05;2.8]mmol/L, HDL of 1.3[1.06;1.57]mmol/L, TG 1.2[0.7;1.6]mmol/L. The medians of the lipid profile in group 1 were not statistically different from those in group 2: TC - 4.85[4.5;7.69]mmol/l, LDL- 2.34[2.03;5.05]mmol/L, HDL- 1.38[1.3;1.6]mmol/L, TG- 1.1[0.9;1.23], p&gt;0.05. Group 3, when compared with groups 1 and 2, had the highest levels of TC - 6.7[5.87;6.8]mmol/L (p = 0.001), LDL - 2.97[2.9;3.8]mmol/L (p = 0.0005), HDL - 1.5[0.6;1.64]mmol/L (p&gt;0.05), and TG 1.9[1.8;2.35]mmol/L (p = 0.002), but did not significantly differed from those in group 4 (p&gt;0.05), where median of TC was 6.32[6.02;6.7]mmol/L, LDL 3.5[2.89;3.28]mmol/L, HDL 0.69[0.6;1.64]mmol/L, and TG 2.1[2.01;2.85]mmol/L, p&lt;0.05 when compared with groups 1 and 2. Median UA levels in group 1 (254 [212;310]mmol/L) was significantly lower (p = 0.011), when compared with patients in groups 2, 3, and 4 (311[301;395], 302[286;407], and 325[305;346], mmol/L, accordingly). There were correlations between the presence of PCAT+AP and levels of TC (r = 0.37; p&lt;0.05), LDL (r = 0.53; p&lt;0.05), TG (r = 0.47; p&lt;0.05), presence of dyslipidemia (r = 0.44; p&lt;0.05), and UA level (r = 0.4; p&lt;0.05). Conclusions: We have demonstrated a relation of metabolic markers (TC, LDL, and UA) not only with atherosclerotic carotid lesion, but also with pathological carotid tortuosity in hypertensive patients.

COGNITIVE FUNCTION IN HYPERTENSIVE PATIENTS WITH DIFFERENT TYPES OF CAROTID LESIONS

Objective: The aim of our research was to study the cognitive function and its relation with the types of carotid arteries lesions (CL) in patients with hypertension. Design and method: 67 hypertensive patients (35 men and 32 women) were examined (median age 51 [45;55] y., hypertension duration 3 [2;5] y). Cognitive function was assessed by the Montreal Cognitive Rating Scale (MoCA). The subjects underwent duplex scanning of the carotid arteries on a Samsung HS50 2021. The results were statistically processed using Statistica 10 program. Results: The patients included in the study were divided into 4 groups according to the type of CL: group 1 (n = 39) without pathological carotid tortuosity (PCAT) and atherosclerotic plaques (AP); group 2 (n = 11) with PCAT, but without AP; group 3 (n = 11) with AP&lt;70% stenosis and without PCAT, and group 4 (n = 6), which has both PCAT and AP&lt;70% stenosis. The groups did not differ significantly in gender and age (p&gt;0.05). Cognitive function levels were significantly higher in group 1 (28[26;29] points) when compared with group 2 (20[19;20] points, p = 0.000001), with group 3 (24[20;26] points, p = 0.00004), and with group 4 (19[19;23] points, respectively, p = 0.00009). In group 2 the MoCA level was significantly lower than in group 3 (p = 0.019). The lowest MoCA level was in group 4, though but because of the small sample of patients, the differences did not reach the level of statistical significance (p&gt;0.05, when compared with group 2). The MoCA level was in negative correlation with the presence of CL (PCAT + AP) (r = -0.77; p&lt;0.05). A similar correlation between the MoCA level and PCAT was in group 2 (r = -0.81; p&lt;0.05). Conclusions: In patients with hypertension, there is a negative correlation between the cognitive function and the presence of different variants of carotid lesions. The most severe decline of cognitive function was observed in hypertensives with both atherosclerotic plaques and pathological carotid tortuosity.

Analysis of the frequency of detection of hypercholesterolemia, carotid atherosclerosis and lipid-lowering therapy prescription in young adults under 45 years old according to the Duplex registry database

Aim of the study to analyze the detection of hypercholesterolemia (HCHL) and carotid atherosclerosis (CAS), verified by duplex scanning of the carotid arteries (DSCA) in young adults (YA), and to evaluate the lipid-lowering therapy (LLT) prescription among them according to the local registry database.&#x0D; Material and Methods: The Duplex registry database was used for this study (n=2548). YA up to 45 years old were selected for the final analysis (n=351).&#x0D; Results: HCHL (&gt; 5 mmol/L) was detected in 68.9% of patients (n=241), and only 9.5% of them received LLT (n=23). CAS was detected in 12.8% (n=45), only 17.8% of them had received LLT (n=8). Men and women differed 1.5 times by the incidence of CAS in this age range: 15.7% (30 out of 191) vs 9.4% (15 out of 160), p=0.05. Men also generally have a higher prevalence of other risk factors/diseases: HCHL (78.0% (n=149) vs 58.1% (n=93) in women, p=0.00004), hypertension (AH) (15.7% (n=30) vs 9.4% (n=15) in women, p=0,05), history of myocardial infarction (MI) (1,6% (n=3) vs 0% (n=0) in women, ns). Signs that had a significant impact on LLT intake were the following: CAS (OR 2.8 [1.09;6.6] p=0.036); AH (OR 3.1 [1.32; 7.16] p=0.009); HCHL (&gt; 5 mmol/L) (OR 4.2 [1.12; 26.83] p=0.06); HCHL (ICD-10 code E78) (OR 5.4 [2.04; 13.7] p=0.0003); MI history (OR 22.3 [1.65;675.5] p=0.009).&#x0D; Conclusion: The insufficient LLT prescription in young adults with HCHL and CAS was ascertained in the present study. The use of imaging methods to clarify the degree of cardiovascular risk is advisable for low and intermediate risk patients, which include young adults. DSСA is the main method for subclinical atherosclerosis verification. LLT should be prescribed to all YA patients with CAS (in the absence of contraindications).&#x0D; Graphical Abstract

Lipid-lowering therapy in patients with arterial hypertension with concomitant chronic obstructive pulmonary disease

Оbjective: in order to evaluate the effects (lipid-lowering, the effect on the endothelial function and oxidative stress) of pitavastatin at a dose of 4 mg in patients with dyslipidemia, arterial hypertension (AH) and chronic obstructive pulmonary disease (COPD) at baseline, after 4 weeks and 12 months of treatment. Material and methods: the prospective study included 33 patients (mean age 60 [54;61] years) with AH, COPD and dyslipidemia. Laboratory examination consisted in determining the lipid spectrum, the level of lipid peroxidation products, creatinine, bilirubin, alanine aminotransferase, aspartate aminotransferase. The endothelium’s function was performed by the test with the endothelium-dependent vasodilation. We prescribed Pitavastatin (4 mg, Livazo, Recordati, Ireland) as a lipid-lowering therapy. After 12 months, the atherosclerotic plaques (AP) in the vessel was seen by the ultrasound duplex scanning of carotid arteries. Results: after 4 weeks of treatment with pitavastatin (4 mg), there was a decrease in total cholesterol — 26%, low-density lipoprotein (LDL) — 33%, triglycerides (TG) — 19%, high-density lipoprotein was increased by 18%. There was an improvement in endothelial dysfunction and oxidative stress. There were no side effects in patients. Conclusion: correction of lipid metabolism disorders in AH patients with COPD by prescribing pitavastatin (4 mg) can reduce total cholesterol, LDL and TG, can positively affect endothelial function and lipid peroxidation processes. Therapy with pitavastatin (4 mg) in patients with dyslipidemia, AH and COPD is safe. It is noted the regression of AP after 12 months of regular intake of pitavastatin at a dose of 4 mg.