COMPLEX EVALUATION PARAMETERS OF CENTRAL AORTIC BLOOD PRESSURE AND MAIN ARTERIES STIFFNESS IN PATIENTS WITH CORONARY ARTERY DISEASE, DEPENDING ON THE PREVALENCE OF ATHEROSCLEROSIS

Objective: to study the parameters of central aortic blood pressure and main arteries stiffness in patients with coronary artery disease (CAD) depending on the prevalence of atherosclerotic lesions. Material and methods: the study involved 90 patients with a diagnosis of unstable angina class II B (E. Braunwald et al., 1989) the control group consisted of 27 healthy people. The method of applanation tonometry using the apparatus of SphygmoCor («AtCor Medical», Australia) studied the performance stiffness: pulse wave velocity (PWV) and augmentation index (AIx). Coronary angiography was performed at the facility Allura CV-20 (Philips, The Netherlands), the state of the carotid arteries was studied by duplex ultrasonography, evaluation of involvement of femoral arteries was based on ankle-brachial index <0.9, in case of doubt, underwent ultrasound duplex scanning. In the main group, patients were divided into 3 subgroups: subgroup A defined patients with isolated coronary lesion; subgroup B was presented by patients who diagnosed combined lesion: coronary arteries with carotid arteries or coronary arteries with femoral arteries; subgroup C was presented with multifocal atherosclerosis patients who had atherosclerosis lesion in three vascular beds: the carotid, coronary and femoral arteries. Results: values PWV (11,2±1,5 m/s), and AIx (19,8±5,0%) in patients with CAD were, respectively, 1.5 (p<0.001) and 2.4 (p<0.001) times higher than in healthy persons. During the intragroup analysis in all three subgroups PWV was accelerated, with maximum values in the subgroup C (13,3±1,5 m/s), which significantly exceeds the value of this index in the subgroup A (10,1±0,6, p<0.01) and B (11,0±0,9, p<0.05). The value of augmentation index AIx was also highest in the subgroup C 26,8±6,4%, relative to the subgroup A (13,7±2,9%, p<0.001) and subgroup B (18,9±4,3%, p<0, 01). Conclusion: the obtained results allow to recommend studied parameters of vascular stiffness as surrogate markers to assess the prevalence and progression of atherosclerosis, as well as efficacy of pharmacological interventions.

coronary artery disease, pulse wave velocity, coronary and multifocal atherosclerosis, ишемическая болезнь сердца, скорость пульсовой волны, коронарный и мультифокальный атеросклероз

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