Cor Vasa 2017, 59(2):e114-e118 | DOI: 10.1016/j.crvasa.2016.04.003

Study of main arteries stiffness in patients with coronary heart disease depending on prevalence of atherosclerosis

U. I. Nizamov^*, F. M. Bekmetova, S. U. Khoshimov, A. B. Shek, R. D. Kurbanov

Republican Specialized Center of Cardiology, Tashkent, Uzbekistan

Objective: To study the vascular wall stiffness in patients with coronary artery disease based on the prevalence of atherosclerotic lesion.

Materials and methods: The study involved 90 patients diagnosed with unstable angina class II B, the control group consisted of 27 healthy individuals. By using the SphygmoCor (AtCor Medical, Australia) apparatus, stiffness indicators, like pulse wave velocity (PWV) and augmentation index (AIx) were studied by means of the applanation tonometry method. Coronary angiography was performed on the Allura CV-20 (Philips, The Netherlands) unit, the state of the carotid arteries was studied by duplex ultrasonography, involvement of femoral arteries was evaluated based on ankle-brachial index < 0.9. In case of doubt, the patients underwent ultrasound duplex scanning. In the main group, patients were divided into 3 subgroups: subgroup A covered patients with isolated coronary lesion; subgroup B covered patients with bifocal atherosclerosis (combined lesion of coronary and carotid arteries or coronary and femoral arteries); subgroup C was represented by multifocal atherosclerosis patients who had atherosclerosis lesion in three vascular basins: carotid, coronary and femoral arteries.

Results: Values of PWV (11.2 ± 1.5 m/s) and AIx (19.8 ± 5.0%) in patients with coronary heart disease were 1.5 (p < 0.001) and 2.4 (p < 0.001) times higher than in those in healthy individuals. During the analysis carried out within the groups, the PWV in all three subgroups was accelerated with maximal values in the subgroup C (13.3 ± 1.5 m/s), which with sufficient level of confidence exceeds the value of this index in the subgroups A (10.1 ± 0.6, p < 0.01) and B (11.0 ± 0.9, p < 0.05). The value of AIx was also highest in the subgroup C (26.8 ± 6.4%), relative to the subgroups A (13.7 ± 2.9%, p < 0.001) and B (18.9 ± 4.3%, p < 0.01).

Conclusion: Patients with coronary heart disease, have demonstrated growing vascular wall stiffness, which is manifested in higher pulse wave velocity (p < 0.001) and augmentation index (p < 0.001) compared with healthy individuals. Whereas in the multifocal atherosclerosis (coronary, carotid and peripheral arteries) were higher AA (p < 0.05), AIx (p < 0.001), PWV (p < 0.01) and the age of patients (p < 0.01). That allows to consider the studied parameters of vascular stiffness as surrogate markers to assess prevalence and progression of atherosclerosis, as well as the effectiveness of pharmacological interventions.

Keywords: Coronary and multifocal atherosclerosis; Coronary heart disease; Pulse wave velocity

Received: January 6, 2016; Revised: April 13, 2016; Accepted: April 14, 2016; Published: April 1, 2017  Show citation