Possibilities of noninvasive diagnostics of cardiovascular diseases associated with atherosclerosis

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Abstract

Background. Despite the global trend towards a decrease in mortality from cardiovascular pathology of atherosclerotic genesis, this group of diseases continues to occupy a leading position in the structure of disability and mortality among the population of many countries.

Aim. Identification of noninvasive markers of arterial wall lesions associated with the presence of arterial hypertension (AH) and coronary heart disease (CHD) in persons younger than 55 years.

Materials and methods. The study included 81 people. Three groups were distinguished from them: 1st (n=31) – a control group of practically healthy individuals, average age – 43 (40; 48) years; 2nd group (n=21) – patients with coronary heart disease without a history of cardiovascular diseases (CVD), average age – 45,5±6,1; group 3 (n=29) – patients with AH without CHD, average age – 47 (35; 50) years. The parameters of a biochemical blood test were determined, volumetric sphygmography and a sample with post-occlusive reactive hyperemia were performed.

Results. In groups of patients with CHD and AH, negative changes in the lipid profile and higher glucose levels were recorded compared to healthy individuals. According to the results of volumetric sphygmography, the pulse wave velocity in arteries of predominantly elastic type (R/L-PWV) in group 1 was 10.1±1.7 m/s, in group 2 – 12.9±1.8 m/s, in group 3 – 13.1 (12; 14) m/s (р1–2=0.029; р1–3<0.001); cardio-ankle vascular index (CAVI) – 6.5±0.7, 7.7 (7; 8.7) and 7.8 (7.3; 8.4), respectively (р1–2<0.001; р1–3<0.001). According to the data of the test with post-occlusive reactive hyperemia, a comparably high frequency of pathological values of flow-dependent vasodilation (FDV) and reactivity index (RI) was demonstrated in patients with CHD and AH (р1–2<0.05; р1–3<0.05). A multifactorial model of noninvasive diagnosis of CHD in individuals without a history of CVD, including non-high-density lipoprotein cholesterol, R/L-PWV, and FDV, has been developed. For patients with AH, glucose, lipid metabolism, R/L-PWV, pulse wave velocity in muscle-type arteries (B-PWV), augmentation index (AI), biological age, CAVI, FDV, RI were the risk factors for the presence of the disease in the anamnesis.

Conclusion. The results obtained confirm the importance of an integrated approach in the screening diagnosis of CVD.

About the authors

Lyudmila I. Salyamova

Penza State University

Email: l.salyamova@yandex.ru
ORCID iD: 0000-0001-7130-0316

Cand. Sci. (Med.)

Russian Federation, Penza

Ksenia I. Pavlenko

Penza State University

Email: ksenia-p2017@mail.ru
ORCID iD: 0009-0003-3002-5815

Assistant

Russian Federation, Penza

Angelina A. Khromova

Penza State University

Email: hromova-a.a@yandex.ru
ORCID iD: 0000-0001-7239-6620

Cand. Sci. (Med.)

Russian Federation, Penza

Valentin E. Oleynikov

Penza State University

Author for correspondence.
Email: v.oleynikof@gmail.com
ORCID iD: 0000-0002-7463-9259

D. Sci. (Med.), Prof.

Russian Federation, Penza

References

  1. Здравоохранение в России. 2021: Стат. сб. Росстат. М. 2021 [Zdravookhranenie v Rossii. 2021: Stat. sb. Rosstat. Мoscow. 2021 (in Russian)].
  2. Российское кардиологическое общество (РКО). Стабильная ишемическая болезнь сердца. Клинические рекомендации 2020. Российский кардиологический журнал. 2020;25(11):4076 [Russian Society of Cardiology (RSC). 2020 Clinical practice guidelines for Stable coronary artery disease. Russian Journal of Cardiology. 2020;25(11):4076 (in Russian)]. doi: 10.15829/29/1560-4071-2020-4076
  3. Virani SS, Alonso A, Benjamin EJ, et al. Heart Disease and Stroke Statistics-2020 Update: A Report From the American Heart Association. Circulation. 2020;141(9):e139-e596. doi: 10.1161/CIR.0000000000000757
  4. Ducrocq G, Bhatt DL, Labreuche J, et al. Geographic differences in outcomes in outpatients with established atherothrombotic disease: results from the REACH Registry. Eur J Prev Cardiol. 2014;21(12):1509-16. doi: 10.1177/2047487313501278
  5. Rotar O, Konradi A, Tanicheva A, et al. May Measurement Month 2017 in Russia: hypertension treatment and control-Europe. Eur Heart J Suppl. 2019;21:D101-3. doi: 10.1093/eurheartj/suz068
  6. Журавлева М.В., Терещенко С.Н., Жиров И.В., и др. Оценка влияния применения лекарственного препарата дапаглифлозин у пациентов с хронической сердечной недостаточностью на достижение целевого показателя федерального проекта «Борьба с сердечно-сосудистыми заболеваниями» – снижение смертности от болезней системы кровообращения. Российский кардиологический журнал. 2021;26(12):4800 [Zhuravleva MV, Tereshchenko SN, Zhirov IV, et al. Effect of dapagliflozin therapy on achieving cardiovascular mortality target indicators in patients with heart failure. Russian Journal of Cardiology. 2021;26(12):4800 (in Russian)]. doi: 10.15829/1560-4071-2021-4800
  7. Радайкина О.Г., Власов А.П., Мышкина Н.А. Роль эндотелиальной дисфункции в патологии сердечно-сосудистой системы. Ульяновский медико-биологический журнал. 2018;4:8-17 [Radaikina OG, Vlasov AP, Myshkina NA. The role of endothelial dysfunction in the pathology of the cardiovascular system. Ulyanovsk Medical and Biological Journal. 2018;4:8-17 (in Russian)]. doi: 10.23648/UMBJ.2018.32.22685
  8. Мычка В.Б., Верткин А.Л., Вардаев Л.И., и др. Консенсус экспертов по междисциплинарному подходу к ведению, диагностике и лечению больных с метаболическим синдромом. Кардио- васкулярная терапия и профилактика. 2013;12(6):41-82 [Mychka VB, Vertkin AL, Vardaev LI, et al. Experts consensus on the interdisciplinary approach towards the management, diagnostics, and treatment of patients with metabolic syndrome. Cardiovascular Therapy and Prevention. 2013;12(6):41-82 (in Russian)].
  9. Небиеридзе Д.В., Камышова Т.В., Сарычева А.А., Сафарян А.С. Структура сердечно-сосудистого риска у пациентов с артериальной гипертонией впервые обратившихся к врачу. Кардиоваскулярная терапия и профилактика. 2018;17(5):5-10 [Nebieridze DV, Kamyshova TV, Sarycheva AA, Safaryan AS. Cardiovascular risk profile in patients with arterial hypertension who first seek medical attention. Cardiovascular Therapy and Prevention. 2018;17(5):5-10 (in Russian)]. doi: 10.15829/1728-8800-2018-5-5-10
  10. Невзорова В.А., Плехова Н.Г., Присеко Л.Г., и др. Методы машинного обучения в прогнозировании исходов и рисков сердечно-сосудистых заболеваний у пациентов с артериальной гипертензией (по материалам ЭССЕ-РФ в Приморском крае). Российский кардиологический журнал. 2020;25(3):3751 [Nevzorova VA, Plekhova NG, Priseko LG, et al. Machine learning for predicting the outcomes and risks of cardiovascular diseases in patients with hypertension: results of ESSE-RF in the Primorsky Krai. Russian Journal of Cardiology. 2020;25(3):3751 (in Russian)]. doi: 10.15829/1560-4071-2020-3-3751
  11. Рекомендации ESC по профилактике сердечно-сосудистых заболеваний в клинической практике. Российский кардиологический журнал. 2022;27(7):5155 [2021 ESC Guidelines on cardiovascular disease prevention in clinical practice. Russian Journal of Cardiology. 2022;27(7):5155 (in Russian)]. doi: 10.15829/1560-4071-2022-5155
  12. Ganda OP, Bhatt DL, Mason RP, et al. Unmet Need for Adjunctive Dyslipidemia Therapy in Hypertriglyceridemia Management. J Am Coll Cardiol. 2018;72(3):330-43. doi: 10.1016/j.jacc.2018.04.061
  13. Бойцов С.А., Кухарчук В.В., Карпов Ю.А., и др. Субклинический атеросклероз как фактор риска сердечно-сосудистых осложнений. Кардиоваскулярная терапия и профилактика. 2012;11(3):82-6 [Boytsov SA, Kukharchuk VV, Karpov YuA, et al. Subclinical atherosclerosis as a risk factor of cardiovascular events. Cardiovascular Therapy and Prevention. 2012;11(3):82-6 (in Russian)]. doi: 10.15829/1728-8800-2012-3-82-86
  14. Бойцов С.А., Погосова Н.В., Аншелес А.А., и др. Кардиоваскулярная профилактика 2022. Российские национальные рекомендации. Российский кардиологический журнал. 2023;28(5):5452 [Boytsov SA, Pogosova NV, Ansheles AA, et al. Cardiovascular prevention 2022. Russian national guidelines. Russian Journal of Cardiology. 2023;28(5):5452 (in Russian)]. doi: 10.15829/1560-4071-2023-5452
  15. Cortese F, Cecere A, Maria Cortese A, et al. Vascular, cardiac and renal target organ damage associated to arterial hypertension: which noninvasive tools for detection? J Hum Hypertens. 2020;34(6):420-31. doi: 10.1038/s41371-020-0307-7
  16. Ватутин Н.Т., Склянная Е.В. Дисфункция эндотелия сосудов как фактор риска развития артериальной гипертензии. Сибирский журнал клинической и экспериментальной медицины. 2017;32(4):23-7 [Vatutin NT, Sklyannaya EV. Endothelial dysfunction as a risk factor of arterial hypertension progression. The Siberian Journal of Clinical and Experimental Medicine. 2017;32(4):23-7 (in Russian)]. doi: 10.29001/2073-8552-2017-32-4-23-27
  17. Lytsy P, Lind L, Sundström J. Endothelial function and risk of hypertension and blood pressure progression: the prospective investigation of the vasculature in Uppsala seniors. J Hypertens. 2013;31(5):936-9. doi: 10.1097/HJH.0b013e32835ed5a0
  18. Горшков А.Ю., Федорович А.А., Драпкина О.М. Дисфункция эндотелия при артериальной гипертензии: причина или следствие? Кардиоваскулярная терапия и профилактика. 2019;18(6):62-8 [Gorshkov AYu, Fedorovich AA, Drapkina OM. Endothelial dysfunction in hypertension: cause or effect? Cardiovascular Therapy and Prevention. 2019;18(6):62-8 (in Russian)]. doi: 10.15829/1728-8800-2019-6-62-68
  19. Хаишева Л.А., Шлык С.В., Самакаев А.С., и др. Изучение жесткости сосудистой стенки у пациентов с артериальной гипертонией в зависимости от некоторых факторов риска и ассоциированных клинических состояний. CardioСоматика. 2019;10(1):6-11 [Khaisheva LA, Shlyk SV, Samakaev AS, et al. Study of vascular wall stiffness in patients with arterial hypertension depending on certain risk factors and associated clinical conditions. Cardiosomatics. 2019;10(1):6-11 (in Russian)]. doi: 10.26442/22217185.2019.1.190187
  20. Королев А.И., Федорович А.А., Горшков А.Ю., и др. Факторы фотоплетизмографии, ассоциированные с наличием невыявленной артериальной гипертонии у мужчин с низким и умеренным сердечно-сосудистым риском. Кардиоваскулярная терапия и профилактика. 2023;22(7):3649 [Korolev AI, Fedorovich AA, Gorshkov AYu, et al. Photoplethysmography factors associated with undiagnosed hypertension in men with low and moderate cardiovascular risk. Cardiovascular Therapy and Prevention. 2023;22(7):3649 (in Russian)]. doi: 10.15829/1728-8800-2023-3649

Supplementary files

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2. Fig. 1. Lipid profile parameters in the compared groups.

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3. Fig. 2. Endothelial function indices according to the reactive hyperemia test in the compared groups.

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