Features of the structural and functional state of the heart in patients at different stages of cerebral atherosclerosis
Post updated: July 19
Cerebrovascular diseases (CVDs) are one of the most important causes of morbidity and mortality among the adult population. Generalized atherosclerosis is the most common cause of damage to the vascular system of the brain, leading to the development of acute and chronic forms of cerebral circulatory disorders (CCD) [11, 15].
One of the most important areas of cardioneurology is the improvement of methods of diagnosis, prevention and therapy of combined cardiac and cerebral diseases. Cerebro-cardiac disorders that occur in the acute period of ischemic stroke are multifaceted. Stroke with functional and morphological brain damage provokes cardiac disorders (arrhythmias, myocardial ischemia). These disorders are especially pronounced in the localization of stroke in the vertebrobasilar basin. Hemispheric features of stroke influence on the functional state of the cardiovascular system have been established. The degree and nature of the violation of the functional state of the heart in stroke patients largely determines the clinical and prognostic design of the course of both the acute and rehabilitation period.
Thus, despite the comparative "youth" of cardioneurology as a scientific field, the role of heart pathology in the pathogenesis of stroke has been determined, some central mechanisms of nervous regulation of heart activity and features of cardiocerebral relationships in the acute period of stroke have been studied. However, to date, the dynamic mechanisms of the formation of features of cerebrocardial relationships in patients with various stages of cerebral atherosclerosis have not been presented.
The purpose of the study.
To conduct a comparative analysis of morphofunctional changes of the heart, intracardial and systemic hemodynamics in elderly patients with cerebral atherosclerosis of 1-3 degrees.
To compare the features of the structural and functional state of the heart, intracardial and systemic hemodynamics in patients with stage 1-3 of dyscirculatory encephalopathy.
To conduct a comparative analysis of the structural and functional state of the heart, intracardial and systemic hemodynamics in elderly patients who have suffered an atherothrombotic stroke, taking into account the hemispheric localization of the ischemic focus.
Materials and methods.
229 patients with cerebral atherosclerosis of 2-3 degrees participated in a comprehensive clinical and instrumental study. The diagnosis of “cerebral atherosclerosis” was formulated in accordance with the WHO classification of atherosclerosis from 2015 and was confirmed by laboratory and instrumental studies (ultrasound dopplerography of cerebral arteries, MRI of the brain).
The design study is simple, prospective, non–randomized, with sequential inclusion of patients. It was conducted on the basis of the Department of vascular pathology of the brain of the State Institution "Institute of Gerontology named after D. F. Chebotarev NAMS of Ukraine". Kyiv.All patients underwent conventional clinical, laboratory (general blood and urine analysis, determination of lipid profile, creatinine, urea, glucose, aspartate aminotransferase, alanine aminotransferase, bilirubin) and instrumental examination (transthoracic echocardiography, ECG, ultrasound dopplerography of head and neck vessels, MRI of the brain) and took standard antihypertensive therapy (ACE inhibitors, antagonists calcium). Echocardiographic studies were performed on the Aplio 300 device (Toshiba, Japan) using a phased sensor PST-30BT 3 MHz, in accordance with the recommendations of the European Society of Cardiology.
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