CAROTID ATHEROSCLEROTIC LESION IN YOUNG PATIENTS
https://doi.org/10.17650/1818-8338-2014-1-28-33
Abstract
Objective: to determine the incidence of atherosclerotic lesions in the carotid and vertebral arteries of young patients from Doppler ultrasound data and to compare the quantitatively assessed traditional risk factors of coronary heart disease (CHD) with severe extracranial artery atherosclerotic lesion.
Subjects and methods. Doppler ultrasound was carried out evaluating structural changes in the aortic arch branches in 1563 railway transport workers less than 45 years of age. A separate sample consisted of 68 young people with carotid atherosclerotic changes, in whom traditional risk factors for CHD were studied, so were in a control group of individuals without atherosclerotic changes (n = 38).
Results. Among the examinees, carotid atherosclerotic lesion was detected in 112 (7.1 %) cases, the increase in the rate of atherosclerotic plaques in patients aged 35–45 years being 9.08 %; that in the rate of local intima-media thickness in those aged 31–40 years being 5.1 %. Smoking (particularly that along with hypercholesterolemia and a family history of cardiovascular diseases), obesity (along with low activity), and emotional overstrain were defined as important risk factors in the young patients. Moreover, factor analysis has shown that smoking,
hypertension, and early cardiovascular pathology in the next of kin makes the greatest contribution to the development of carotid atherosclerotic lesion.
Conclusion. Among the patients less than 45 years of age, carotid and vertebral artery atherosclerotic changes were found in 112 (7.1 %) cases, which were more pronounced in male patients. Smoking, particularly along with hypercholesterolemia and genetic predisposition to cardiovascular diseases, was a risk factor that had the highest impact on the degree of atherosclerotic lesion in the aortic arch branches of the young patients.
About the Authors
N. V. PizovaRussian Federation
D. S. Druzhinin
Russian Federation
References
1. Гусев Е.И., Скворцова Л.В., Стаховская Л.В. и др. Эпидемиология инсульта в России. Consilium Мedicum. Неврология 2003; (Спец. выпуск):5–7.
2. Дзяк Г.В., Коваль Е.А. Клинико-иммунологические критерии оценки прогноза и лечения атеросклероза и ревматизма. Журн АМН України 1998;4(1):78–87.
3. Kaski J.C., Zouridakis E.G. Inflammation, infection and acute coronary plaque events. Eur Heart J 2001;3(Suppl 1):10–5.
4. Maseri A., Cianflone D. Inflammation in acute coronary syndromes. Eur Heart J 2002;4(Suppl B):8–13.
5. Lüscher T.F., Tschudi M.R., Wenzel R.R., Noll G. Endothelial dysfunction and nitrogen monoxide (NO; nitric oxide). Internist (Berl) 1997;38(5):411–9.
6. Moncada S., Palmer R.M., Higgs E.A. Nitric oxide: physiology, pathophysiology and pharmacology. Pharmacol Rev 1991;43(2):109–42.
7. Wissler R.W. The problems of procedures for the study of the pathological processes of human atherosclerosis. In: Pathobiology of the Human Atherosclerotic Plaque. S. Glagov, W.P. Newman III, S.A. Schaffer (eds.). New York: Springer-Verlag, 1990; 263–70.
8. Relationship of atherosclerosis in young men to serum lipoprotein cholesterol concentrations and smoking. A preliminary report from the Pathobiological Determinants of Atherosclerosis in Youth (PDAY) Research Group. JAMA 1990;264(23):3018–24.
9. Wissler R.W., Vesselinovitch D. An update on the pathogenesis of atherosclerosis (principles of prevention, intervention, retardation, and regression). Hawaii Med J 1990;49(7):237–40, 261.
10. MRC European Carotid Surgery Trial: interim results for symptomatic patients with severe (70–99 %) or with mild (0–29 %) carotid stenosis. European Carotid Surgery Trialists' Collaborative Group. Lancet 1991;337(8752):1235–43.
11. Volkow N.D., Mullani N., Gould K.L. et al. Cerebral blood flow in chronic cocaine users: а study with positron emission tomography. Br J Psychiatry 1988;152:641–8.
12. Деев А.С., Захарушкина И.В. Церебральные инсульты в молодом возрасте Журн неврол и психиатр им. С.С. Корсакова 2000;100(1):14–7.
13. Pignoli P., Tremoli E., Poli A. et al. Intimal plus medial thickness of the arterial wall: a direct measurement with ultrasound imaging. Circulation 1986;74(6):1399–406.
14. Mancia G., De Backer G., Dominiczak A. et al. 2007 Guidelines for the management of arterial hypertension: the task force for the management of arterial hypertension of the European society of hypertension (ESH) and of the European society of cardiology (ESC). J Hypertens 2007;25(6):1105–87.
15. Балахонова Т.В., Алехин М.Н. Материалы 5-го Съезда врачей УЗИ. 2007.
16. Никитин Ю.М., Труханов А.И. Ультразвуковая допплеровская диагностика сосудистых заболеваний. М.: Видар, 1998. 432 с.
17. Gray-Weale A.C., Graham J.C., Burnett J.R. et al. Carotid artery atheroma: comparison of preoperative B-mode ultrasound appearance with carotid endarterectomy specimen pathology. J Cardiovasc Surg 1988;29(6):676–81.
18. Кузьмина Л.П., Тарасов А.А., Хайбулина А.З. Клинико-биохимические изменения при воздействии производственных стресс-факторов у шахтеров-угольщиков. Медицина труда и промышленная экология 2001;(8): 42–5.
19. Friedewald W.T., Levy R.I., Fredrickson D.S. Estimation of the concentration of low-density lipoproteins of plasma, without use of the preparative ultracentrifuge. Clin Chem 1972;18(6):499–502.
20. Persson J., Stavenow L., Wikstrand J. et al. Noninvasive quantification of atherosclerotic lesions. Reproducibility of ultrasonographic measurement of arterial wall thickness and plaque size. Arterioscler Tromb 1992;12(2):261–6.
21. McGill H.C. Jr., McMahan C.A., Malcom G.T. et al. Effects of serum lipoproteins and smoking on atherosclerosis in young men and women. The PDAY Research Group. Pathobiological Determinants of Atherosclerosis in Youth. Arterioscler Thromb Vasc Biol 1997;17(1):95–106.
22. Strong J.P., Oalmann M.C., Malcom G.T.; Pathobiological Determinants of Atherosclerosis in Youth (PDAY) Research Group. Atherosclerosis in youth: relationship of risk factors to arterial lesions. In: Monograph on prevention of atherosclerosis and hypertension beginning in youth. R.M. Lauer, R.V. Luepker, L.J. Jr. Filer (eds.). Malvern P.A.: Lea and Febiger, 1994; 13–8.
23. Strong J.P. Natural history and risk factors for early human atherogenesis. Pathobiological Determinants of Atherosclerosis in Youth (PDAY) Research Group. Clin Chem 1995;41(1):134–8.
24. Jain S., Mathur S., Mathur A. et al. Effect of tobacco use on arterial stiffness in community dwelling females. J Assoc Physicians India 2012;60:20–3.
Review
For citations:
Pizova N.V., Druzhinin D.S. CAROTID ATHEROSCLEROTIC LESION IN YOUNG PATIENTS. The Clinician. 2014;8(1):28-33. (In Russ.) https://doi.org/10.17650/1818-8338-2014-1-28-33