КОМПЛЕКСНАЯ ОЦЕНКА ПАРАМЕТРОВ ЦЕНТРАЛЬНОГО АОРТАЛЬНОГО ДАВЛЕНИЯ И ЖЁСТКОСТИ МАГИСТРАЛЬНЫХ АРТЕРИЙ У БОЛЬНЫХ ИШЕМИЧЕСКОЙ БОЛЕЗНЬЮ СЕРДЦА В ЗАВИСИМОСТИ ОТ РАСПРОСТРАНЁННОСТИ АТЕРОСКЛЕРОЗА

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.