Extraand intracranial circulation in patients with ischemic heart disease

Autor: V. S. Moroshkin, N. V. Moroshkina, I. B. Zueva, A. V. Panov, O. M. Moiseeva
Rok vydání: 2012
Předmět:
Zdroj: "Arterial’naya Gipertenziya" ("Arterial Hypertension"). 18:153-157
ISSN: 2411-8524
1607-419X
DOI: 10.18705/1607-419x-2012-18-2-153-157
Popis: Objective. To study the frequency and degree of atherosclerotic lesions of eхtra- and intracranial vessels in patients with coronary artery disease (CAD) before coronary arteriography and planned cardiac intervention. Design and methods. 100 patients with CAD, angina pectoris I-III functional class were examined: 58 men aged 48-72 years old (mean age — 58 ± 3 years) and 42 women aged 37-68 years old (57 ± 2 years). Duration of CAD varied from several weeks to 15 years (mean duration — 10 ± 2 years). Extra- and intracranial vessels were examined by Duplex scanning with colour Doppler (Vivid 7Pro, HP, the USA). Results. Atherosclerotic lesions of the common carotid arteries (CCA) with stenoses from 17 to 45 % awere revealed in 78 % males and 54 % females. Atherosclerotic plaques in a mouth of internal carotid arteries (ICA), narrowing vessel lumen from 25 to 57 %, were found in 38 % males and 20 % females, stenoseis from 25 to 34 % in brachiocephalic trunk (BCT) and in right subclavian arterys (SА) — in 30 and 18 % in males, and in 34 and 14 % in females, respectively. The right CCA was found to be S-shaped in 10 patients, both CCA were S-shaped in 8 subjects. Pathological S-shaped curve of IСА was found in 4 men and 7 women. Pathological trace of the vertebral arteries (VA) was found in 10 subjects. Hypoplasia of the right VA was visualized in 3 patients and hypoplasia of the left one — in two cases. S-shaped curve of VA was visualised in I segment in 23 % subjects, more frequently in females. 57 % subjects showed a moderate decrease of cerebrovascular reactivity. Mean decrease of reactivity was 18 % on hypercapnic load, 13 % on hypocapnic test, and 15 % decrease of vasomotor reactivity was observed. Conclusions. In one third of patients with CAD atherosclerotic lesions of extracranial vessels and local abnormalities of haemodynamics in the area of pathological curve caused the changes of brain circulation. Presence of a double gradient of systolic speed between proximal and distal segments (against the pathological curve) was the most significant indicator of local haemodynamic abnormalities in the curved extracranial arteries.
Databáze: OpenAIRE
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