Cardiocerebral relationships and telomere length at different stages of cerebral atherosclerosis: myth or fact?
Post updated: July 19
The idea of the relationship between cardiac and cerebral pathology is of undoubted interest among doctors of various specialties, dynamically expanding due to the improvement of instrumental diagnostic methods and the growth of cardiovascular mortality. However, to date, no dynamic mechanisms of the formation of cerebrocardial relationship features in patients with various stages of cerebral atherosclerosis have been presented.
Objective: to identify the relationship between indicators of heart rate variability (HRV), structural and functional state of the heart and cerebral vessels, telomere length, and telomerase activity in patients with stage 1-3 cerebral atherosclerosis (CA).
Materials and methods: 229 patients with CA of the 2nd – 3rd degree took part in a comprehensive clinical and instrumental study. At the first stage, the patients were divided into 2 groups: I –– with CA of 1–2 degree (without AI - comparison group); II - a general group of patients after an ischemic atherothrombotic stroke. Subsequently, patients from 55 to 75 years old participated in the comparison of groups. All patients underwent instrumental examination (transthoracic echocardiography, electrocardiography (ECG), duplex scanning of the vessels of the head and neck). At the second stage, out of 229 patients, 84 patients were selected, who, in addition to the above studies, measured telomere length and telomerase activity.
Results and discussion: in chronic cerebrovascular diseases, a steadily progressing atherosclerotic process is accompanied by a decrease in blood flow velocity in the main arteries of the head. Moreover, changes in LSSC are detected by transcranial dopplerography at earlier stages both at the extra- and intracranial levels, and blood flow depression initially occurs in 2 pools: in the arteries of the vertebro-basilar pool and in the carotid bed. The identification of changes in a Doppler study, in general, precedes the increase in symptoms of organic damage to the nervous system. Compared with patients with initial manifestations of CA, patients who underwent AI are characterized by a thickening of CMM, a statistically significant decrease in LSS in individual vessels of the carotid and vertebro-basilar basins on both sides. In the group we were analyzing, a statistically significant difference in the rate of cerebral blood flow was observed only in the vessels of the carotid basin on the right. The number of correlations in patients who underwent AI is 2.5 times greater than in patients without AI, which indirectly indicates, first of all, impaired autoregulation of cerebral blood flow after AI, but also a very small number of connections may suggest the absence of close interaction of the brain-heart system in this category of patients. It is interesting to note that the relationship of cerebral blood flow with the autonomic nervous system in post-stroke patients is not observed at all, but is present in patients with stage 1-2 CA.
And finally, the answer to the most important question: do patients with CA of different stages have a connection between geometry, myocardial mass and left ventricular diastolic dysfunction, autonomic modulation with a long telomere - a marker of cell aging? Yes, they are undoubtedly connected, but telomerase activity probably has nothing to do with this, which requires further study on the largest possible sample of patients.
See the full text of the article below.
Objective: to identify the relationship between indicators of heart rate variability (HRV), structural and functional state of the heart and cerebral vessels, telomere length, and telomerase activity in patients with stage 1-3 cerebral atherosclerosis (CA).
Materials and methods: 229 patients with CA of the 2nd – 3rd degree took part in a comprehensive clinical and instrumental study. At the first stage, the patients were divided into 2 groups: I –– with CA of 1–2 degree (without AI - comparison group); II - a general group of patients after an ischemic atherothrombotic stroke. Subsequently, patients from 55 to 75 years old participated in the comparison of groups. All patients underwent instrumental examination (transthoracic echocardiography, electrocardiography (ECG), duplex scanning of the vessels of the head and neck). At the second stage, out of 229 patients, 84 patients were selected, who, in addition to the above studies, measured telomere length and telomerase activity.
Results and discussion: in chronic cerebrovascular diseases, a steadily progressing atherosclerotic process is accompanied by a decrease in blood flow velocity in the main arteries of the head. Moreover, changes in LSSC are detected by transcranial dopplerography at earlier stages both at the extra- and intracranial levels, and blood flow depression initially occurs in 2 pools: in the arteries of the vertebro-basilar pool and in the carotid bed. The identification of changes in a Doppler study, in general, precedes the increase in symptoms of organic damage to the nervous system. Compared with patients with initial manifestations of CA, patients who underwent AI are characterized by a thickening of CMM, a statistically significant decrease in LSS in individual vessels of the carotid and vertebro-basilar basins on both sides. In the group we were analyzing, a statistically significant difference in the rate of cerebral blood flow was observed only in the vessels of the carotid basin on the right. The number of correlations in patients who underwent AI is 2.5 times greater than in patients without AI, which indirectly indicates, first of all, impaired autoregulation of cerebral blood flow after AI, but also a very small number of connections may suggest the absence of close interaction of the brain-heart system in this category of patients. It is interesting to note that the relationship of cerebral blood flow with the autonomic nervous system in post-stroke patients is not observed at all, but is present in patients with stage 1-2 CA.
And finally, the answer to the most important question: do patients with CA of different stages have a connection between geometry, myocardial mass and left ventricular diastolic dysfunction, autonomic modulation with a long telomere - a marker of cell aging? Yes, they are undoubtedly connected, but telomerase activity probably has nothing to do with this, which requires further study on the largest possible sample of patients.
See the full text of the article below.
