Thickness Of Intima-media Complex Research Articles

Mean Carotid Intima-Media Thickness in Patients with Type 2 Diabetes Mellitus Attending Tertiary Care Center: A Descriptive Cross-sectional Study.

Sonographic carotid intima media thickness measurement in diabetic patients is an important tool for estimating the risk of cardiovascular and cerebrovascular events. It is a simple, noninvasive and widely available tool which can give idea of further treatment needed. The objective of this study was to determine the mean intima media complex thickness in patients with type II diabetes mellitus attending a tertiary care center. This was a descriptive cross-sectional study done in 64 patients with the type II diabetes mellitus patients visiting diabetic clinic of Tribhuvan University Teaching Hospital, sent for carotid Doppler examination in the department of radiology and imaging. Ethical approval was taken from the Instituitonal Review Board. Convenient sampling method was used. Carotid intima media thickness was measured on both sides and mean intima media thickness was calculated. Mean intima media thickness for male and female diabetic patients was also calculated separately. Statistical Package for Social Sciences version 25 was used for data analysis. The mean carotid intima media thickness was 0.86±0.13mm with range from 0.7mm to 1.3mm. Mean intima media thickness in male was 0.832±0.094mm and in female it was 0.904±0.144mm. Among 64 patients, 30 (46.8%) were female and 34 (53.3%) were male. Age of the patients ranged from 35 years to 68 years with mean age of 52.4±6.54 years. Carotid intima media thickness in patients with type II diabetes mellitus showed higher values than that of mean value from study done in similar study. Female had higher mean intima media thickness than male.

Assessment of renal glomerulosclerosis and thickness of the carotid intima-media complex as a means of age estimation in Western European bodies

IntroductionThe estimation of age-at-death of unidentified cadavers is a central aspect of the identification process. With increasing age, the incidence of glomerulosclerosis and the thickness of the carotid wall have been observed to also increase. This correlation has been demonstrated in various international histological studies. The aim of our study was to assess whether these correlations also apply to a Western European population.MethodologyIn this retrospective observational study, kidney and common carotid artery samples from 216 cases autopsied at the Institute of Legal Medicine at the Justus-Liebig University in Giessen, Germany, were examined. Only cases with available tissue samples from both body sides were included. Exclusion criteria were poor sample quality and an age younger than 21 years. After histological processing, the tissue samples were assessed and digitally evaluated. Regression and classification analyses were used to investigate the correlation between age-at-death and intima-media thickness and age-at-death and the incidence of renal glomerular sclerosis.ResultsOf the 216 autopsy cases, 183 were included for evaluation. Analysis of the carotid artery segments showed a strong correlation (Pearson correlation coefficient r = 0.887) between the intima-media-complex thickness and chronological age. Classification of the glomerulosclerotic incidence showed a correlation of 37.7–43.1% with the predicted age group.DiscussionBoth the intima-media thickness and the proportion of sclerotic glomeruli can be used to estimate age in Western European cadavers. On the basis of these results, both methods are suited to supplement other already established methods for age-at-death estimation in the identification of an unknown cadaver.

Особенности липидного обмена и толщины комплекса интима-медиа у молодых пациентов с субклиническим гипотиреозом

Актуальность. В статье представлен анализ данных литературы и результаты собственных ретроспективных исследований о наличии дислипидемии и изменения толщины комплекса интима-медиа у лиц молодого возраста с субклиническим гипотиреозом в практике семейного врача. Цель исследования: оценить и проанализировать наличие дислипидемии и утолщение комплекса интима-медиа у пациентов молодого возраста с субклиническим гипотиреозом. Материалы и методы. Комплексно обследовано 134 человека. Все обследованные были распределены на две группы. Первая (I) группа - 114 пациентов с аутоиммунным тиреоидитом (АИТ) и вторая (II) группа - 20 человек, без признаков тиреоидной патологии. В зависимости от тиреоидной дисфункции и І группу разделено на две подгруппы: І а подгруппа - 94 пациентов с лабораторно подтвержденным субклиническим гипотиреозом и I б подгруппа - 20 пациентов в стадии эутиреоза. Такое распределение пациентов позволил достоверно выявить и оценить наличие дислипидемии, толщину комплекса интима-медиа (КИМ) и проанализировать их в соответствии с тиреоидным статусом. Методология исследования основана на системном подходе и анализе с использованием методов семантического оценивания научных документов и сравнения. Результаты. Повышенный уровень общего холестерина (ХС) выявлено: в I а подгруппе - 49 (34,04 %) пациентов (5,39 ± 0,24 ммоль/л), в I б подгруппе - 2 (10,0 %) пациентов (5,05±0,07 ммоль/л). Уровень липопротеидов низкой плотности (ЛПНП) ˃2,6 ммоль/л был обнаружен у 80,85 % пациентов І а подгруппы и у 35,0 % пациентов І б подгруппы. Следует отметить, что наибольшие изменения липидного спектра происходили именно у больных I а подгруппы, которые превышали аналогичные показатели у лиц II группы - без признаков тиреоидной дисфункции. При анализе показателей І а подгруппы была установлена прямая сильная корреляционная связь между уровнем тиреотропного гормона (ТТГ) и толщиной КИМ с обеих сторон (r = 0,77). Кроме того, установлена корреляционная связь между уровнем общего ХС, ЛПНП и толщиной КИМ (r = 0,67 и r = 0,62) с обеих сторон. Выводы. Было установлено характерные признаки раннего развития субклинического атеросклероза общей сонной артерии (ОСА), которые зависели от тиреоидной дисфункции. Изменения показателей липидного профиля и толщины КИМ ОСА достоверно отличались от аналогичных показателей у пациентов без тиреоидной патологии.

Clinical Significance of Carotid Intima-Media Complex and Carotid Plaque Assessment by Ultrasound for the Prediction of Adverse Cardiovascular Events in Primary and Secondary Care Patients.

Recently published recommendations from the American Society of Echocardiography on ‘Carotid Arterial Plaque Assessment by Ultrasound for the Characterization of Atherosclerosis and Evaluation of Cardiovascular Risk’ provoked discussion once more on the potential clinical applications of carotid intima-media complex thickness (CIMT) and carotid plaque assessment in the context of cardiovascular risk in both primary and secondary care patients. This review paper addresses key issues and milestones regarding indications, assessment, technical aspects, recommendations, and interpretations of CIMT and carotid plaque findings. We discuss lacks of evidence, limitations, and possible future directions.

Ультразвукові та біохімічні показники дисфункції ендотелію при геморагічному васкуліті у дітей

З метою виявлення ультразвукових і біохімічних маркерів дисфункції ендотелію залежно від ступеня активності та форми обстежено 60 дітей з геморагічним васкулітом. Проводили визначення в сироватці крові концентрації МСР-1 імуноферментним методом, вмісту оксиду азоту — за концентрацією його стабільних метаболітів — NO2, NO3 та S-нітрозотіолу, фактора Віллебранда — агрегометричним методом, оцінку товщини комплексу інтима-медіа загальної сонної артерії та визначення ендотелійзалежної дилатації плечової артерії. Рівні фактора Віллебранда та МСР-1 вірогідно підвищуються залежно від ступеня активності геморагічного васкуліту. Статистичні дані вказують на значне зниження концентрації метаболітів оксиду азоту в сироватці крові у дітей зі змішаною формою та нирковим синдромом. Товщина комплексу інтима-медіа загальної сонної артерії збільшувалась у дітей із тяжким перебігом геморагічного васкуліту та у дітей зі змішаною формою з нирковим синдромом. Зафіксована патологічна реакція ендотелійзалежної дилатації плечевої артерії незалежно від ступеня активності та форми геморагічного васкуліту свідчить про безпосереднє залучення в патологічний процес ендотелію.

Assessment of calcium antagonist therapy protective effect on the thickness of the intima-media complex in patients with arterial hypertension

Aim. To evaluate the connection of calcium antagonist (amlodipine) therapy with the dynamics of the intima-media complex thickness in patients with arterial hypertension (AH), depending on genetic polymorphism.Methods. The study included representatives of the indigenous nationality (the Shors) – 901 people, of which a group of 367 people with hypertension was identified. The prospective stage of observation included 234 people who did not receive antihypertensive therapy. Based on the prescription of calcium antagonists, patients with hypertension were divided into two groups. Gene polymorphism was tested by polymerase chain reaction.Results. In the Shor cohort, the regression of the intima-media complex thickness of the carotid arteries was observed more often in hypertensive patients who received calcium antagonists if to compare them with those who did not take the drug [OR = 2.30]. In addition, the decrease in the atherosclerotic process is associated with the genotype carriage: I/I of the ACE gene [OR = 9.42], T/C of the AGT gene [OR = 3.52], 4b/4b and 4b/4a of the eNOS gene [OR = 2.26 and OR = 3.75], C/C of the MTHFR gene [OR = 2.62].Conclusion. Pharmacogenetic aspects are valuable from the point of view of an individual approach and obtaining the most pronounced pharmacological response in order to slow down the processes of vascular wall remodeling in patients with hypertension.

The state of carotid artery wall in hypertensive patients with gout based on the study of inflammatory markers

The aim. To analyze the frequency of atherosclerotic lesions of the carotid arteries and association with the lipid metabolism and inflammatory markers in hypertensive patients with gout. Materials and methods. 122 patients with hypertension aged 30 to 65 years were examined (mean age (56.0 (47.0; 62.0)), inclu­ding 104 men (85.2 %) and 18 women (14.8 %). Group 1 included 72 hypertensive patients with gout; group 2 – 50 hypertensive patients without gout; group 3 – 20 gout patients without hypertension. Serum levels of high sensitivity C-reactive protein were detected by enzyme-linked immunosorbent assay. Serum ferritin levels were measured using electrochemiluminescent detection. The patients underwent carotid artery ultrasound according to standard methods. Results. The duration of gout exacerbation and the pain intensity evaluated with the visual analog scale (VAS) (P < 0.01) were significantly higher in group 1, than those in group 3 (P < 0.01). Serum ferritin levels were 2.6 (P < 0.01) times higher in group 1 than those in group 2. In patients with gout, the levels of ferritin were significantly 2.1 times higher, than in group 2 (P < 0.01). The levels of hsСRP in patients of group 1 were 3.1 times higher than those in group 2 (P < 0.01). The proportion of patients with intima-media complex (IMC) thickness ≥0.9 mm was higher in group 1 than in groups 2 (χ2 = 4.58, P < 0.05) and 3 (χ2 = 24.96, P < 0.01). In the structure of plaques, isoechoic were significantly more often seen among group 1 patients as compared to group 3 (χ2 = 6.56, P < 0.01), and hyperechoic – as compared to group 2 (χ2 = 4.63, P < 0.05). Hypoechoic plaques were detected in groups 1 and 2 with similar frequency (P > 0.05). This type of plaque was associated with a high risk of cerebrovascular events. In the patients with arterial hypertension and gout, a significant moderate positive correlation was found between the IMC thickness and the serum uric acid level (rs = 0.46, P < 0.01), hsCRP (rs = 0.33, P < 0.01), age (rs = 0.33; P < 0.01), duration of gout (rs = 0.27, P < 0.05) and VAS (rs = 0.39, P < 0.01); the level of hsCRP was correlated with the presence of atherosclerotic plaques (τ = +0.64, P < 0.05). Conclusions. The combination of hypertension with gout in patients was associated with a high incidence of IMC thickness ≥0.9 mm and atherosclerotic plaques, more severe disorders of purine and lipid metabolism, increased inflammatory markers (ferritin and hsCRP), that should be considered not only in the aspect of chronic inflammation, but also as a part of the disease.

Preclinical atherosclerosis in cystic fibrosis: Two distinct presentations are related to pancreatic status

BackgroundPatients with cystic fibrosis (CF) are exposed to overlapping cardiovascular risk factors. We hypothesized that CF is characterized by increased arterial stiffness and greater intima-media thickness (IMT). MethodsThis cross-sectional study assessed the digital volume pulse arterial stiffness index (SIDVP) using photopletysmography, measured intima-media complex thickness (IMT) at the common carotid artery, and obtained an extended set of clinical and atherosclerosis-related laboratory parameters. ResultsFifty-five patients with moderate-to-severe CF (mean age 26.3±8.6 years, BMI 20.3±3.1 kg/m2, FEV1 62±26%) and 51 healthy controls (25.1±4.4 years, BMI 21.7±3.0 kg/m2) entered the study. SIDVP was greater in pancreatic insufficient (PI), but not pancreatic sufficient (PS) CF patients compared with control (7.3±1.8 m/s vs 6.0±1.2 m/s; p=7.1 × 10−5). IMT was increased in PS (but not PI) participants relative to control (552±69 µm vs 456±95 µm, p=0.0011). SIDVP was also greater in PI than in PS patients (7.3±1.8 m/s vs 6.3±1.7 m/s, p=0.0232) and IMT was higher in PS compared with PI (552±69 µm vs 453±82 µm, p=0.0002). SIDVP independently associated with age, PI, the lack of liver cirrhosis, and with Pseudomonas aeruginosa colonization. PS was the only independent correlate of IMT in CF. ConclusionsPI patients are at risk of developing general arterial stiffness. PS may relate to carotid IMT thickening, which underscores the need for further study that could lead to reconsideration of dietary guidance in PS CF.

Should Ultrasonographic Giant-Cell Arteritis Signs be Detected in Patients with Polymyalgia Rheumatica?

Assessing the presence of ultrasonographic findings of Giant-Cell Arteritis in Polymyalgia Rheumatica patients using Ultrasonography on the temporal artery. The study contributes to the literature evaluating the unclear relationship between Polymyalgia Rheumatica and Giant-Cell Arteritis. It raises awareness that Ultrasonography can be used instead of biopsy in patients with suspected Giant-Cell Arteritis. Twenty patients were newly diagnosed with Polymyalgia Rheumatica, and 20 participants as a control group were included in the study. While the Polymyalgia Rheumatica group was evaluated at baseline and sixth month, the control group was evaluated only at baseline. Laboratory, clinical and ultrasonographic findings of all participants were assessed. Gray-scale Ultrasonography and colored Doppler Ultrasonography were used to present halo and compression, occlusion, and stenosis in addition to intima-media complex thickness in bilateral temporal arteries and frontal-parietal branches by an experienced radiologist blinded to the subject. No significant difference was found between Polymyalgia Rheumatica and control groups based on demographic features, clinical and ultrasonographic results at baseline and sixth month. Erythrocyte sedimentation rate of Polymyalgia Rheumatica at baseline was statistically higher than the control group. Erythrocyte sedimentation rate values have declined significantly in Polymyalgia Rheumatica patients, but no significant changes were found for clinical or ultrasonographic features during the sixth month. Ultrasonographic findings of Giant-Cell Arteritis are not present in newly diagnosed and six months followed up Polymyalgia Rheumatica patients. Further studies are needed.

Should Ultrasonographic Giant-Cell Arteritis Signs be Detected in Patients with Polymyalgia Rheumatica?

Assessing the presence of ultrasonographic findings of Giant-Cell Arteritis in Polymyalgia Rheumatica patients using Ultrasonography on the temporal artery. The study contributes to the literature evaluating the unclear relationship between Polymyalgia Rheumatica and Giant-Cell Arteritis. It raises awareness that Ultrasonography can be used instead of biopsy in patients with suspected Giant-Cell Arteritis. Twenty patients were newly diagnosed with Polymyalgia Rheumatica, and 20 participants as a control group were included in the study. While the Polymyalgia Rheumatica group was evaluated at baseline and sixth month, the control group was evaluated only at baseline. Laboratory, clinical and ultrasonographic findings of all participants were assessed. Gray-scale Ultrasonography and colored Doppler Ultrasonography were used to present halo and compression, occlusion, and stenosis in addition to intima-media complex thickness in bilateral temporal arteries and frontal-parietal branches by an experienced radiologist blinded to the subject. No significant difference was found between Polymyalgia Rheumatica and control groups based on demographic features, clinical and ultrasonographic results at baseline and sixth month. Erythrocyte sedimentation rate of Polymyalgia Rheumatica at baseline was statistically higher than the control group. Erythrocyte sedimentation rate values have declined significantly in Polymyalgia Rheumatica patients, but no significant changes were found for clinical or ultrasonographic features during the sixth month. Ultrasonographic findings of Giant-Cell Arteritis are not present in newly diagnosed and six months followed up Polymyalgia Rheumatica patients. Further studies are needed.

Metabolic Syndrome as a Factor Affecting on Intima-Media Thickness in Patients with Rheumatoid Arthritis

AIM: The aim of the study was to assess the association of the thickness of the intima-media complex with metabolic syndrome (MetS) and the degree of disease activity in patients with rheumatoid arthritis (RA). MATERIALS AND METHODS: The study included 101 patients with RA. All patients underwent a biochemical examination, the presence of MetS was determined, and the carotid thickness of the intima-media was determined. Statistical processing was performed using SPSS for Windows, version 18.0. RESULTS: Among 101 patients with RA, 41 (40.5%) had MetS. The frequency of detecting an increased value of the intima-media complex thickness was significantly higher in the group with MetS (n = 31 [75.6%]) than in the group without MetS (n = 21 [35.0%] p ≤ 0.0001). In the group of patients with MetS, the median carotid intima-media thickness (CIMT) was 1.2 mm, while this indicator in the group without MetS was 0.78 mm (U = 727, p = 0.001). In the regression model, MetS (B = 1.05; p = 0.027) and DAS28-ESR (B = 0.506; p = 0.021) were influenced by CIMT. CONCLUSIONS: The results of our study show the effect of MetS and RA activity on the increase of intima-media thickness.

Associations of continuous glucose monitoring-assessed glucose variability with intima-media thickness and ultrasonic tissue characteristics of the carotid arteries: a cross-sectional analysis in patients with type 2 diabetes

BackgroundThe association between glucose variability and the progression of atherosclerosis is not completely understood. We aimed to evaluate the associations of glucose variability with the progression of atherosclerosis in the early stages.MethodsWe conducted a cross-sectional analysis to investigate the associations of glucose variability, assessed by continuous glucose monitoring, with intima-media thickness (IMT) and gray-scale median (GSM) of the carotid arteries, which are different indicators for the progression of atherosclerosis. We used baseline data from a hospital-based multicenter prospective observational cohort study among Japanese patients with type 2 diabetes without a history of cardiovascular diseases aged between 30 and 80 years. Continuous glucose monitoring was performed by Freestyle Libre Pro, and glucose levels obtained every 15 min for a maximum of eight days were used to calculate the metrics of glucose variability. IMT and GSM were evaluated by ultrasonography, and the former indicates thickening of intima-media complex in the carotid artery wall, while the latter indicates tissue characteristics.ResultsAmong 600 study participants (age: 64.9 ± 9.2 (mean ± SD) years; 63.2%: men; HbA1c: 7.0 ± 0.8%), participants with a larger intra- and inter-day glucose variability had a lower GSM and most of these associations were statistically significant. No trend based on glucose variability was shown regarding IMT. Standard deviation of glucose (regression coefficient, β = − 5.822; 95% CI − 8.875 to − 2.768, P < 0.001), glucose coefficient of variation (β = − 0.418; − 0.685 to − 0.151, P = 0.002), mean amplitude of glycemic excursion (β = − 1.689; − 2.567 to − 0.811, P < 0.001), mean of daily differences (β = − 6.500; − 9.758 to − 3.241, P < 0.001), and interquartile range (β = − 4.289; − 6.964 to − 1.614, P = 0.002) had a statistically significant association with mean-GSM after adjustment for conventional cardiovascular risk factors, including HbA1c. No metrics of glucose variability had a statistically significant association with IMT.ConclusionsContinuous glucose monitoring-assessed glucose variability was associated with the tissue characteristics of the carotid artery wall in type 2 diabetes patients without cardiovascular diseases.

IL-6 AND IL-10 ACTIVITY IN HYPERTENSIVE MEN WITH MODERATE OR HIGH CARDIOVASCULAR RISK

Objective: To assess IL-6, IL-10 activity in hypertensive men with moderate or high cardiovascular risk (CVR). Design and method: 60 hypertensive men with moderate and high CVR were included. Two groups were formed: 1st - 30 hypertensive men with moderate CVR; 2nd - 30 men with high CVR. Control group - 15 men, 45–62 years old, without chronic diseases and hypertension. Anamnesis collection, CVR study, general examination, biochemical blood test, ECG, ECHO were held. IL-6, IL-10 were determined by the enzyme-linked immunosorbent assay method. The Mann-Whitney nonparametric test was used for groups comparison. The statistical significance of different values was determined by using the Pearson's Chi-square test. Correlation analysis was carried out on the basis of Spearman's nonparametric rank correlation. Results: IL-10 activity: moderate risk group - 5.18 [3.74; 7.03] pg/ml, high-risk group - 4.92 [2.96; 6.36] pg/ml, control group - 6.63 [5.90; 9.07] pg/ml. There was a statistically significant IL-10 decrease in the high-risk group in comparison with the control group (p = 0.0175). IL-6 activity: moderate risk group - 1.55 [0.75; 2.68] pg/ml, high-risk group - 1.16 [0.48; 2.41] pg/ml, control group - 1.02 [0.00; 9.83] pg/ml, there were no statistically significant differences in the groups. Correlation analysis revealed a multidirectional relationship between IL-10 and the hypertension duration in two groups: with a high risk a negative correlation was revealed (R = - 0.5, p &lt; 0.01), with a moderate risk a positive correlation was revealed (R = 0.46, p &lt; 0.05). IL-6 positively correlated with the thickness of the carotid artery intima-media complex (R = 0.41, p &lt; 0.05) in men with moderate CVR. Conclusions: IL-10 decrease was revealed in hypertensive men with high CVR as compared to the healthy people. It can be used as an additional criterion for high CVR. The negative IL-10 correlation with the hypertension duration reflects the unfavorable development of hypertension in hypertensive men with high CVR. The detection of high IL-6 values in hypertensive men indicates the risk of endothelial dysfunction.

Early signs of airflow restriction and cardiovascular damage in conditionally healthy smokers

Tobacco smoking is one of the most widespread and at the same time difficult to control risk factors for chronic noncommunicable diseases, which make the most significant contribution to the mortality. Smoking intensity, development of airflow restrictions, and damage to vascular endothelium are connected to the accelerated development of atherosclerosis. At the same time, there is no evidence of a possible relationship between the development of myocardial dysfunction and exposure to tobacco combustion products. It is of interest to study the incidence of airflow restrictions, arterial hypertension, and markers of early damage to target organs - the brachiocephalic arteries (BCA) and myocardium, in so-called relatively healthy smoking individuals. The aim of the study was to describe the incidence of airflow restrictions, hypertension, the state of the brachiocephalic arteries, and indicators of global and regional longitudinal strain of the left ventricle (GLSLV and RLSLV) in actively smoking conditionally healthy individuals. Methods. 100 active smokers were examined (smoking person index or ICH &gt; 10 (17 ± 2 packs/year)) at the mean age of 48,80± 0,68years. 55% of the patients were male. The diagnosis of COPD was made based on spirometry values before and after the test with bronchodilators (400 mcg of salbutamol) (FEV1/FVC &lt; 70% and FEV1 increase &lt;12% of the initial values). Blood pressure measurement, duplex scanning of brachiocephalic arteries, transthoracic echocardiography with GLSLV and RLSLV with 17-segment division by Strain method were performed in all patients. Results. COPD was diagnosed in 35% of the patients, hypertension - in 45%. Evaluation of BCA showed increased thickness of intimamedia complex in the patients with hypertension (р= 0.002) and a significantly higher degree of stenosis and number of plaques in patients with concomitant COPD and hypertension. Type 1 diastolic dysfunction of LV was detected both in patients with hypertension and in the patients with COPD, but it was most common in the patients with concomitant COPD and hypertension. The GLSLV values did not change in all patients, but the RLSLV values depended on the segment (basal, medial, apical) and were significantly lower in the patients with concomitant COPD and hypertension. Conclusion. Tobacco combustion products not only are risk factors of airflow restriction and systemic vascular dysfunction, but also cause preclinical myocardial damage, a marker of which is a violation of the longitudinal strain of the left ventricle.

Lack of evidence of the correlation between plasma Asymmetrical Dimethylarginine correlation and IMT in type 2 diabetic patients with chronic vascular complication.

Patients with type 2 diabetes represent 50% of all sudden cardiac deaths. Disseminated arteriosclerotic lesions are the cause of vascular incidents that cause permanent disability resulting from lower limb amputations. Our study was designed to investigate the relationship between asymmetrical dimethylarginine (ADMA), symmetric dimethylarginine (SDMA) plasma concentration and intima-media thickness (IMT) in subjects with diabetes mellitus without vascular complications (group A) and a group of diabetic patients diagnosed with diabetes micro- and macroangiopathy (group B). The experimental groups included 42 diabetic patients. Group A - 22 patients (9 W and 13 M), free from vascular complications (mean age 55.83±7.37 years), group B - 20 patients (6 W, 14 M) with accompanying micro- and macropathic changes (mean age 63.80±8.79 years). Group C (n=22), the control group, consisted of healthy volunteers (12 W and 10 M), between the ages of 40 to 60 (mean age 51.16±6.39), selected in reference to the age and sex of the research group. The carotid artery intima-media complex thickness (IMT) was evaluated with the use of a duplex ultrasound. There was no correlation between ADMA and the maximal or mean intima-media thickness (IMT) of the common carotid artery (CCA) and internal carotid artery (ICA). We demonstrated a correlation between symmetric dimethylarginine (SDMA) concentration and CCA IMT. The results suggest that ICA IMT may serve as a marker of vascular complication among patients with diabetes.

Vascular markers of cognitive dysfunction in patients with uncontrolled arterial hypertension

The presence of arterial hypertension (AH) leads to the development of cognitive dysfunction, in the genesis of which a significant role is assigned to vascular factors. Aim. To study the state of cognitive function and associated vascular factors in patients with uncontrolled AH. Materials and methods. The research involved 88 patients with uncontrolled AH (UAH) — group 1 (median age 60, men — 39%) and 46 patients with controlled AH (CAH) — group 2 (median age 59, men — 41%). Cognitive function was assessed using the Montreal Cognitive Assessment (MoCA). There were studied vascular factors: thickness of the intima-media complex (IMC), pulse wave velocity (PWV), microcirculation flow index (MFI) and asymmetric dimethylarginine (ADMA) concentrations. For the statistical analysis the following criteria were used: Student t-test, Mann—Whitney test. Multifactorial linear regression analysis was performed in groups. Results. In Group 1, there was a lower cognitive function index by MoCA — 24 [22; 26] points against 26 [25; 27] points in Group 2 (p = 0.002). IMC thickness was higher in Group 1 than in Group 2 (1.1 [0.90; 1.20] mm vs 1.0 [0.80; 1.10] mm, p = 0.042), concentration of ADMA was higher in Group 1 (0.73 ± 0.21 µmol/l vs 0.65 ± 0.1 µmol/l, p = 0.02), MFI was higher in Group 2 (30.6 [27.1; 34.4] perf. units vs. 22.8 [18.6; 26.1] perf. units, р &lt; 0.001). No differences between the groups were found in PWV. In regression analysis, the following factors had a statistically significant effect on MoCA scores: in Group 1 — age, IMC thickness, ADMA and MFI; in Group 2 — age and glomerular filtrate rate. Conclusion. Patients with uncontrolled AH have more pronounced cognitive dysfunction than those with controlled AH, which is associated with increased IMC thickness, impaired microcirculation and increased ADMA concentration.

Study of Arterial Stiffness - Based on Scientific Evidence, What are the Current Tools for the Study of Arterial Stiffness?

One of the biggest challenges in modern medicine is the early identification of patients with higher cardiovascular risks. The early identification of vascular damage in hypertensive patients is a challenge for cardiologists around the world in their attempt to reduce the risk of cardiovascular complications in patients. We know how important it is today to measure the thickness of the carotid intima-media complex through ultrasound examination in order to identify a greater or lesser cardiovascular risk. Arterial stiffness has proven [...]

Does Varicella Zoster Virus in Children Affect Temporal Artery Structure or Blood Flow?

Introduction: Varicella-Zoster Virus (VZV) is a member of the Herpesviridae family of viruses and causes two different clinical conditions. The main objective of our study is not to diagnose GCA but instead, we wanted to assess whether there is a structural or flow change following VZV during childhood using US in temporal artery, which is the most commonly affected artery by GCA in advanced age and to review whether the patients show any clinical symptoms related with GCA. Materials and Methods: The study was designed as a prospective single-blind study and included 30 patients diagnosed with varicella under 16 by the same pediatrician and shows infection characteristics. Results: None of the patients included in the study showed halo signs. Moreover, none of the patients showed compression signs, occlusion, or stenosis results. The mean value for intima-media complex thickness was measured as 0.25mm (0.18 - 0.27mm) in a common superficial temporal artery. Conclusion: Chickenpox patients did not show any ultra sonographic changes in their temporal artery and no clinical symptoms related to GCA, yet we think that the relationship between VZV infection and GCA development warrants further studies with larger series and longer follow-up periods.

Vascular remodeling with violations of intracardiac hemodynamics in patients older age category, combined with the clinical-cluster, neurocognitive and biomarker heterogeneity in multifocal atherosclerosis

Study of the remodeling of the carotid arteries with violation of intracardiac hemodynamics in patients with MFA, and the estimation of the main parameters of dyslipidemia, apoptosis, and oxidative stress in patients with high vascular risk older age group (6175 years) in a Regional vascular center of Ufa. Depending on the predominant lesion of the vascular pool, patients were divided into 3 clusters by the method of hierarchical analysis of categorical variables according to the clinical manifestation of atherosclerotic lesions of the heart, brain and lower limb arteries confirmed by coronary angiography, ultrasound Doppler of the main arteries of the head and lower extremities. 96 of them were IPA with a primary lesion of the heart (1st cluster), the 96 IPA with a predominance of lesions of the carotid arteries (2nd cluster), 96 patients with ischemia of lower extremities (3rd cluster). At the hospital stage, electrocardiography, echocardiography, magnetic resonance imaging of the chest and abdomen, ultrasound of the OBP and kidneys, if necessary, ultrasound of the pelvis were performed. Determination of 8-ON-deoxyguanosine, annexin-5 (An-5) and Aan-5 in blood by ELISA was performed in all patients with MFA, as well as standard biochemical screening for lipidogram examination. We have found that most often in different combinations and with different degrees of severity according to our data are observed: Clinical manifestation of atherosclerotic heart disease (cluster 1) mainly due to its history in combination with stage III hypertension with increasing thickness of intima-media complex and stenosis of the right WASP, left ventricular dilatation, as well as a higher concentration of Aan-5IgMand LP-A as a risk factor for coronary heart disease, atherosclerosis, atherothrombosis. 2. Hemodynamically significant violations of the main arteries of the head in patients of the 2nd cluster mainly with acute ischemic cerebral circulation, in which there was a development of left ventricular hypertrophy with an increase in the size of the left atrium and the presence of atherosclerotic plaque of the right and left WASP. The higher prevalence of stroke was combined with a marked cognitive deficit among patients of cluster 2 with the lowest level of An-5, an increase in total cholesterol and low-density lipoprotein cholesterol. 3. The total severity of the condition in patients with hemodynamic ischemia with clinical manifestation of vascular lesions of the lower extremities was accompanied by a predominant increase in stable angina with FC2, lerish syndrome with occlusion of the iliac, superficial femoral arteries, the presence of insulin-independent type 2 diabetes, which in this group was established in 59.4% of cases, combined with a higher concentration of the marker of oxidative stress 8-ON-deoxyguanosine and hypertriglyceridemia. The construction of a three-cluster model in patients at high vascular risk of the elderly age category showed the interaction of cardio-carotid comorbid background on the clinical diversity of systemic vascular lesions in MFA with the development of remodeling of the main arteries and disorders of intracardiac hemodynamics associated with laboratory changes in the assessment of the main parameters of dyslipidemia, apoptosis markers, oxidative stress.

Predicting the development of ischemic stroke in patients with cerebral atherosclerosis and diabetes mellitus

Cerebrovascular pathology and metabolic disorders are problems of modern health care, which are of colossal medical and social significance. A high percentage of not only mortality, but also disability determines the extreme urgency of studying their various aspects, and the presence of combined pathology requires the development of a personalized approach to the tactics of managing such patients.&#x0D; The aim of our study is to predict the development of IS based on indicators of the structural and functional state of the heart and cerebral vessels and heart rate variability in patients with cerebral atherosclerosis (CA) and DM2. Materials and methods. The complex clinical and instrumental study involved 229 patients with CA 1–3 degrees. Study design: simple, prospective, non-randomized, sequential enrollment. All patients underwent instrumental examinations: transthoracic echocardiography, electrocardiography ECG, ultrasound Doppler of the vessels of the head and neck, MRI of the brain. All patients took antihypertensive and antidiabetic drugs, antiplatelet agents, statins. Results: Patients were divided into 2 groups: I - with CA 1–2 degrees, II - with CA 3 degrees (after ischemic atherothrombotic stroke (IS)). Average age = 65.1 ± 10.5 and 65.4 ± 9.1 years, respectively. The share of men was 21.2% in the 1st and 52% in the 2nd groups. The number of patients with type 2 diabetes, mean fasting glucose and glycosylated hemoglobin levels were comparable in both groups. At the time of examination, all patients achieved the target BP and T2DM compensation. In our study, for patients with CA, a negative relationship between ischemic stroke and end-diastolic size index and a positive relationship with the thickness of the interventricular septum and male sex was established, which logically explains the important role of LV geometry in the development of ischemic stroke. For patients with T2DM, a negative relationship was found between ischemic stroke and LV diastolic function and positive - with fasting glucose and IM thickness.&#x0D; Conclusion: Based on multivariate regression analysis, in patients with cerebral atherosclerosis with the development of ischemic stroke, the presence of a relationship between the thickness of the interventricular septum, end-systolic size index, end-diastolic size index and the male sex was revealed (AUC = 0.94 (CI 0.91 - 0.97), but in patients with DM2 and CA - fasting glucose level, interventricular septum thickness, intima-media complex thickness and E/A AUC = 0.99 (95% CI 0.94 - 1.00).