Arterial stiffness in patients with atherosclerosis and dyslipidemia on drug therapy as a possible marker of residual risk.

Abstract

Abstract

In patients with CVD with atherosclerosis and dyslipidemia on  drug therapy, the residual risk (RR) of cardiovascular complications  remains high. Arterial stiffness (AS) can be considered as an integral marker of RR.

The aim: to study the parameters of regional and local AS in patients with CVD with atherosclerosis and dyslipidemia on  drug therapy to determine possible markers of RR.

Materials and methods: 48 CVD patients with atherosclerosis and dyslipidemia aged 35 to 76 (60±10) years were examined: 20 women and 28 men, who were consulted by cardiologists at the National Medical Research Center of Cardiology named after Academician E.I. Chazov Ministry of Health of the Russian Federation  and receiving complex drug therapy. Atherosclerosis  of the brachiocephalic arteries were detected in 48 patients (100%), coronary arteries in 31 (64%), hemodynamically significant lesions of the arteries of the lower extremities in 9 (18%), arterial hypertension in 37 (77%), diabetes mellitus in 8 (16 %), a history of myocardial infarction in 12 (25%), in 6 acute cerebrovascular accident. Regional AS was studied by volumetric sphygmography using the VaSera 1000 by parameter CAVI, local AS of the common carotid (CCA), brachial (BA) and radial arteries (RA) by ultrasound using the Aloka Prosound α 7 with echo-tracking technology  by parameters: stiffness index β , elastic modulus Petersona Ер (kPa) , arterial compliance  (AC) (mm2/kPa).

Results: The coefficient of variation of AS indicators ranged from 13 to 63%. Exceeding the age reference values ​​of CAVI was determined in 25%, β  CCA index in 19%. Statistically significant positive correlations of the CAVI index with age, systolic (SBP), pulse (PBP) and mean BP (mean BP); local stiffness of CCA with age, with SBP and mean BP; local stiffness of the RA with SBP and DBP were identified

Conclusion: In patients with CVD with atherosclerosis and dyslipidemia on  drug therapy, the parameters of regional and local AS are associated with age and BP level. Exceeding the age reference values ​​of the stiffness index of the aorta and large main arteries CAVI was observed in every fourth patient. The  CAVI  can be considered as a possible marker of RR. Further studies are needed to confirm this hypothesis.