cardioКардиологияKardiologiia0022-90402412-5660Kardiomag10.18087/cardio.2019.5.2581cardio-655Research ArticleАТЕРОСКЛЕРОЗATHEROSCLEROSISПоказатели эндотелиальной скорости сдвига в сонной артерии как маркер системного атеросклероза и сердечнососудистых заболеваний, обусловленных атеросклерозомCarotid Wall Shear Rate as a Marker of Systemic Atherosclerosis and Atherosclerotic Cardiovascular DiseaseГенкельВ. В.GenkelV. V.

Genkel Vadim V. – research assistant

Chelyabinsk

henkel-07@mail.ruШапошникИ. И.ShaposhnikI. I.ФГБОУ ВО «Южно-Уральский государственный медицинский университет» Минздрава РоссииРоссияSouth Ural State Medical UniversityRussian Federation2019250520195954552Copyright © Kardiomag, 20192019KardiomagKardiomaghttps://cardio.elpub.ru/jour/about/submissions#copyrightNoticehttps://cardio.elpub.ru/jour/article/view/655Цель исследования

Цель исследования. Оценить возможность использования cкорости сдвига на эндотелии (ССЭ) сонной артерии в качестве маркера системного атеросклероза и атеросклеротических сердечно-сосудистых заболеваний (ССЗ).

Материалы и методы

Материалы и методы. В исследование включили 200 пациентов с различным риском развития ССЗ, из которых 142 пациента имели одно или более атеросклеротических ССЗ. Всем пациентам проводили ультразвуковое сканирование сонных артерий (СА) и артерий нижних конечностей с измерением лодыжечно-плечевого индекса. Каротидную ССЭ определяли при ультразвуковом сканировании СА в соответствии с законом Хагена–Пуазейля.

Результаты

Результаты. ССЭ в исследуемой когорте пациентов составляла 434±139 с–1. По результатам ROC-анализа было установлено, что ССЭ ниже порогового значения 300 с–1 позволяла прогнозировать у пациента атеросклеротическое ССЗ с чувствительностью 97,1 % и специфичностью 84,6 %. ЭСС менее 300 с–1 ассоциировалась с увеличением относительного риска (ОР) наличия у пациента атеросклеротических ССЗ в 11,2 раза (при 95 % доверительном интервале от 1,26 до 99,3; p=0,03) с поправкой на такие факторы, как пол, возраст, курение, ожирение, артериальная гипертензия, скорость клубочковой фильтрации, уровень холестерина липопротеинов низкой плотности, высокочувствительного С-реактивного белка, толщина интимы–медии общей сонной артерии. Модель, включающая каротидную ССЭ, а также такие факторы, как сахарный диабет 2го типа, ожирение, пол, возраст пациента и скорость клубочковой фильтрации, позволяют диагностировать сочетанное атеросклеротическое поражение периферических артерий с чувствительностью 73,1 % и специфичностью 90,3 %.

Заключение

Заключение. Оценка ССЭ сонной артерии позволяет с удовлетворительной чувствительностью и специфичностью диагностировать у пациентов сочетанный атеросклероз периферических артерий и атеросклеротических ССЗ. 

Aim

Aim: to assess possibility of the use of carotid wall shear rate (WSR) as a marker of systemic atherosclerosis and atherosclerotic cardiovascular disease (ASCVD).

Materials and methods

Materials and methods. We included into this study 200 patients with different cardiovascular risk (142 patients already had one or more ASCVD). All patients underwent ultrasound scanning of carotid and lower limb arteries with measurement of the ankle-brachial index. Carotid WSR was determined during ultrasonic scanning of carotid arteries in accordance with the Hagen-Poiseuille law.

Results

Results. Mean WSR value in this cohort of patients was 434±139 s–1. Based on the results of the ROCanalysis, it was found that WSR below the threshold value of 300 s–1 allowed to predict the presence of ASCVD with sensitivity of 97.1 % and specificity of 84.6 %. WSR <300 s–1 was associated with relative risk (RR) of ASCVD presence 11.2 (95 % CI 1.26–99.3, p=0.03), adjusted for factors such as sex, age, smoking, obesity, hypertension, estimated glomerular filtration rate (eGFR), low density lipoprotein cholesterol, and high sensitivity C-reactive protein, carotid intima-media thickness. The model which included carotid WSR, as well as factors such as the presence of type 2 diabetes, obesity, sex, age, eGFR, allowed to diagnose combined atherosclerotic lesions of peripheral arteries with a sensitivity of 73.1 % and a specificity of 90.3 %.

Conclusion

Conclusion. Evaluation of the carotid WSR allows to diagnose with satisfactory sensitivity and specificity the presence of combined atherosclerosis of peripheral arteries and ASCVD. 

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The authors declare that there are no conflicts of interest present.