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An abdominal aortic calcification as a RISK FACTOR FOR cardio -cerebral events in patients with peripheral arterial

https://doi.org/10.17650/1818-8338-2012-3-4-33-37

Abstract

Background. The patients with abdominal aortic calcification have a high risk of cardiocerebral events, but the pathways of them have not been reported so far. The goal of our study was to assess the structure and function of myocardium and to determine the morphological features of carotid artery atherosclerosis in patients with abdominal aortic calcification.


Materials and methods. A total of 167 executive patients with peripheral arterial disease were enrolled in study. The study group included 85 patients with abdominal aortic calcification (men – 95.3 %; age median was – 66.6 ± 12). Control group included 82 patients without objective signs of abdominal aortic calcification. Abdominal aortic calcification was detected by CT imaging. All patients have undergone echocardiography and duplex scanning of carotid arteries.


Results. Prevalence and severity of ischemic heart disease and cerebrovascular disease were statistically significant higher in patients with abdominal aortic calcification (91.7, 65.8 % vs. 67, 37.3 % (р < 0.01)). We have found statistically significant differences between groups
in heart structure and function. A high left ventricular wall thickness (р < 0.01), left atrium dilation (р < 0.01) and enhanced of left ventricular mass (р < 0.05), ejection fraction reduction (р < 0.05) and more common diastolic dysfunction (р < 0.05) were determined in
patients with abdominal aortic calcification. An intima-media thickness of the common carotid artery was significantly higher in study group patients (1.38 ± 0.07 mm vs. 1.14 ± 0.06 mm (р < 0.001)).


Conclusion. Our findings suggested that abdominal aortic calcification is main reason of hypertrophy and dilation in the left heart due to enhanced peripheral resistance. Hypertrophy and dilation in the left heart is provided a high risk of cardiovascular events in patients with
abdominal aortic calcification.

About the Authors

V. A. Zelinskiy
North-Western State Medical University named after I.I. Mechnikov, Ministry of Health of Russia
Russian Federation


M. V. Melnikov
North-Western State Medical University named after I.I. Mechnikov, Ministry of Health of Russia
Russian Federation


A. Ye. Barsukov
North-Western State Medical University named after I.I. Mechnikov, Ministry of Health of Russia
Russian Federation


V. V. Andreev
North-Western State Medical University named after I.I. Mechnikov, Ministry of Health of Russia
Russian Federation


References

1. Клиническая ангиология: руководство. Под ред. А.В. Покровского. В 2 т. М.: Медицина, 2004.

2. Norgren L., Hiatt W.R., Dormandy J.A. et al.; TASC II Working Group. Inter-Society Consensus for the Management of Peripheral Arterial Disease (TASC II). J Vasc Surg 2007;45 Suppl. S:S5–67.

3. Heald C.L., Fowkes F.G., Murray G.D. et al. Risk of mortality and cardiovascular disease associated with the ankle-brachial index: Systematic review. Atherosclerosis 2006;189(1):61–9.

4. Wild S.H., Byrne C.D., Smith F.B. et al. Low ankle-brachial pressure index predicts increased risk of cardiovascular disease independent of the metabolic syndrome and conventional cardiovascular risk factors in the Edinburgh Artery Study. Diabet Care 2006;29(3):637–42.

5. Eggen D.A., Strong J.P., McGill H.C. Jr. Calcification in the abdominal aorta: relationship to race, sex, and coronary atherosclerosis. Arch Pathol 1964;78:575–83.

6. Iribarren C., Sidney S., Sternfeld B., Browner W.S. Calcification of the aortic arch: risk factors and association with coronary heart disease, stroke, and peripheral vascular disease. JAMA 2000;283(21):2810–5.

7. Witterman J.C., Kannel W.B., Wolf P.A. et al. Aortic calcified plaques and cardiovascular disease (the Framingham Study). Am J Cardiol 1990;66(15):1060–4.

8. Danielsen R., Sigvaldason H., Thorgeirsson G., Sigfússon N. Predominance of aortic calcification as an atherosclerotic manifestation in women: The Reykjavík study. J Clin Epidemiol 1996;49(3):383–7.

9. Wilson P.W., Kauppila L.I., O'Donnell C.J. et al. Abdominal aortic calcific deposits are an important predictor of vascular morbidity and mortality. Circulation 2001;103(11):1529–34.

10. Rodondi N., Taylor B.C., Bauer D.C. et al. Association between aortic calcification and total and cardiovascular mortality in older women. J Intern Med 2007;261(3):238–44.

11. Lang R.M., Bierig M., Devereux R.B. et al.; Chamber Quantification Writing Group; American Society of Echocardiography's Guidelines and Standards Committee; European Association of Echocardiography. Recommendations for chamber quantification: a report from the American

12. Society of Echocardiography's Guidelines and Standards Committee and the Chamber Quantification Writing Group, developed in conjunction with the European Association of Echocardiography, a branch of the European Society of Cardiology. J Am Soc Echocardiogr 2005;18(12):1440–63.

13. Шиллер Н., Осипов М.А. Клиническая эхокардиография. 2-е изд. М.: Практика, 2005.

14. Schwammenthal E., Popescu B.A., Popescu A.C. et al. Association of left ventricular filling parameters assessed by pulsed wave Doppler and color M-mode Doppler echocardiography with left

15. ventricular pathology, pulmonary congestion, and left ventricular end-diastolic pressure. Am J Cardiol 2004;94(4):488–91.

16. 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.

17. Magaña-Serrano J.A., Almahmeed W., Gomez E. et al.; I PREFER Investigators. Prevalence of Heart Failure With Preserved Ejection Fraction in Latin American, Middle Eastern, and North African Regions

18. in the I PREFER Study (Identification of Patients With Heart Failure and PREserved Systolic Function: An Epidemiological Regional Study). Am J Cardiol 2011;108(9):1289–96.

19. Yan R.T., Bluemke D., Gomes A. et al. Regional left ventricular myocardial dysfunction as a predictor of incident cardiovascular events MESA (multi-ethnic study of atherosclerosis). J Am Coll Cardiol 2011;57(17):1735–44.

20. Wachtell K., Palmieri V., Gerdts E. et al. Prognostic significance of left ventricular diastolic dysfunction in patients with left ventricular hypertrophy and systemic hypertension (the LIFE Study).

21. Am J Cardiol 2010;106(7):999–1005.

22. Sheridan D.J. Left Ventricular Hypertrophy. London: Churchill Livingstone, 1998.

23. Reinier K., Dervan C., Singh T. et al. Increased left ventricular mass and decreased left ventricular systolic function have independent pathways to ventricular arrhythmogenesis in coronary artery disease. Heart Rhythm 2011;8(8):1177–82.

24. Jaramillo A., Ramírez A., Galleguillos L. et al. Ischemic stroke as the first manifestation of severe ventricular hypertrabeculation/non-compaction. Arq Bras Cardiol 2010;94(3):28–30.

25. Benjamin E.J., D’Agostino R.B., Belanger A.J. et al. Left atrial size and the risk of stroke and death. The Framingham Heart Study. Circulation 1995;92(4):835–41.

26. Bauml M.A., Underwood D.A. Left ventricular hypertrophy: an overlooked cardiovascular risk factor. Cleve Clin J Med 2010;77(6):381–7.

27. Grosset D.G., Georgiadis D., Abdullah I. et al. Doppler emboli signals vary according to stroke subtype. Stroke 1994;25(2):382–4.

28. Fuentes B., Garces M.C., Diez Tejedor E. et al. Endothelial dysfunction markers in stroke patients. Cerebrovasc Dis 2002;13(Suppl 3):31.

29. Folsom A.R., Eckfeldt J.H., Weitzman S. et al. Relation of carotid artery wall thickness to diabetes mellitus, fasting glucose and insulin, body size, and physical activity. Atherosclerosis Risk in Communities (ARIC) Study Investigators. Stroke 1994;25(1):66–73.


Review

For citations:


Zelinskiy V.A., Melnikov M.V., Barsukov A.Ye., Andreev V.V. An abdominal aortic calcification as a RISK FACTOR FOR cardio -cerebral events in patients with peripheral arterial. The Clinician. 2012;6(3-4):33-37. (In Russ.) https://doi.org/10.17650/1818-8338-2012-3-4-33-37

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