Title ULTRAZVUK KAROTIDNIH ARTERIJA U PROCJENI SUPKLINIČKE ARTERIOSKLEROZE KOD ISPITANIKA SA ČIMBENICIMA RIZIKA Title (english) Carotid ultrasonography in the evaluation of subclinical arteriosclerosis in patients with risk factors for atherosclerosis Author Krunoslav Buljan Mentor Silva Butković Soldo (mentor)Committee member Vesna Šerić (predsjednik povjerenstva)Granter Josip Juraj Strossmayer University of Osijek Defense date and country 2016-07-08, Croatia Scientific / art field, BIOMEDICINE AND HEALTHCARE Universal decimal classificationUDC ) 61 - Medical sciences Abstract CILJ ISTRAŽIVANJA: Glavni cilj istraživanja bio je ispitati specifičnosti pojedinih strukturnih i funkcionalnih ultrazvučnih (UZV) pokazatelja supkliničke arterioskleroze u ovisnosti o najznačajnijim čimbenicima rizika za aterosklerozu, dobi i spolu. Dodatni cilj bio je ispitati eventualnu povezanost UZV markera supkliničke arterioskleroze s ljestvicama procjene kardiovaskularnog (CV) rizika i njihov mogući utjecaj na klasifikaciju pojedinaca u rizične kategorije. ISPITANICI I METODE: U
... More istraživanje, koje je dizajnirano kao presječno, bilo je uključeno 245 CV zdravih ispitanika (125 žena) raspona životne dobi između 32 i 59 godina, srednje dobi 49,5 godina. Odvojeno po spolu formirane su grupe ispitanika prema kriteriju prisutnosti jednog od triju CV rizičnih čimbenika (arterijska hipertenzija, dijabetes melitus tip 2, pušenje cigareta), te dvije kontrolne skupine ispitanika bez rizičnih čimbenika. Između formiranih skupina ispitanika nije bilo značajne dobne razlike. Na temelju UZV pregleda karotidnih arterija u B-prikazu detektirani su strukturni pokazatelji, a istovremenim mjerenjem krvnog tlaka i pulsatilnih oscilacija lumena izračunati su indeksi elastičnosti i krutosti arterijske stijenke. REZULTATI: Debljina stijenke (CIMT), vaskularna masa, površina poprečnog presjeka stijenke i omjer debljina stijenke/lumen karotidnih arterija pokazuju najveću alteraciju u dijabetičnim skupinama, odnosno prema kontrolnim skupinama statistički su značajno promijenjeni u dijabetičnim i hipertenzivnim skupinama (p < 0,001). Koeficijent rastezljivosti (DC), koeficijent popustljivosti i B indeks krutosti upućuju na smanjenje elastičnosti i povećanje krutosti karotidne stijenke kod dijabetičnih i hipertenzivnih ispitanika obaju spolova (p < 0,001). Između žena pušačica i kontrolne skupine nije utvrđena značajnost razlika UZV markera supkliničke arterioskleroze (p > 0,05), dok su kod muškaraca pušača DC i B značajno različiti od rezultata kontrolne skupine (p < 0,05). Pozitivna je povezanost dobi i rezultata UZV testova kod ispitanika obaju spolova (Pearsonov koeficijent korelacije 0,472 - 0,608, p < 0,001). Između žena i muškaraca približno iste dobi utvrđena je značajna razlika (p < 0,001) u smislu izraženijih arteriosklerotskih promjena kod muškaraca. Korištenjem CIMT-a kao dodatnog kriterija u procjeni CV rizika Framinghamskom rizičnom skalom približno 70% žena reklasificirano je u višu, a oko 10% u nižu rizičnu kategoriju, a 123 korištenjem karotidnog aterosklerotskog plaka kao dodatnog kriterija iz više srednjerizične u kategoriju visokog rizika reklasificirano je oko 80% muškaraca. ZAKLJUČAK: Ultrazvuk karotidnih arterija omogućava detekciju ranih strukturnih i funkcionalnih promjena arterijske stijenke koje odgovaraju supkliničkoj arteriosklerozi. Less Abstract (english) OBJECTIVES: The main objective of the research was to examine the specifics of individual structural and functional ultrasonography indicators of subclinical arteriosclerosis, depending on the most important risk factors for atherosclerosis, age and gender. An additional objective was to examine the possible relation of ultrasound markers of subclinical arteriosclerosis charts with assessment of cardiovascular (CV) risks and their possible impact on the classification of individuals
... More into risk categories. PARTICIPANTS AND METHODS: The study, designed as a cross-sectional study, included 245 CV healthy subjects (125 women) age ranging from 32 to 59 years; mean age was 49.5 years. Patients were distributed in gender groups according to the criteria of the presence of one of the three CV risk factors (hypertension, type 2 diabetes mellitus, cigarette smoking), and two control groups of patients without any risk factors. Significant age difference was not found in any of the formed groups. Carotid ultrasound examinations in the B-mode marked structural indicators. Simultaneous measurement of blood pressure and pulsatile fluctuation of lumen enabled the calculation of the elasticity index and the arterial wall stiffness. RESULTS: Carotid intima-media thickness (CIMT), vascular mass, cross-sectional area and the ratio of wall thickness / lumen of the carotid arteries show the highest alteration in diabetic groups, i.e. according to the control groups these parameters were significantly altered in diabetic and hypertensive groups (p < 0.001) respectivelly. Distensibility coefficient (DC), compliance coefficient (CC) and beta stiffness index (P) indicate a reduction in elasticity and increase in the stiffness of the carotid wall material in diabetic and hypertensive subjects of both sexes (p < 0.001). A significant diference in ultrasound markers of subclinical arteriosclerosis has not been found in comparison of women smokers and control groups (p > 0. 05), while in male smokers DC and B are significantly different than in the control group (p < 0.05). There is a positive correlation between age and the results of ultrasound tests in the subjects of both sexes (Pearson correlation coefficient from 0.472 to 0.608, p < 0.001). A significant diference has been found when comparing women and men of the same age in 125 terms of pronounced arteriosclerosis change, wich is higher in men (p <0.001). Introducing CIMT as the additional criteria in assessing CV risk by Framingham Risk Score led to reclassification of approximately 70% of women to a higher, and about 10% in a lower risk category. The use of carotid atherosclerotic plaque as an additional criteria led to reclassification of approximately 80% of men from medium-risk category to the high risk category. CONCLUSION: Carotid ultrasonography enables early detection of structural and functional alterations of the arterial wall material that match subclinical arteriosclerosis. Less Keywords
arterioskleroza
ateroskleroza
rizični faktori
karotidne arterije
ultrazvuk
Doppler
124
Keywords (english)
arteriosclerosis
atherosclerosis
risk factors
carotid arteries
ultrasonography
Doppler
126
Language croatian URN:NBN urn:nbn:hr:152:932762 Study programme Title: University Postgraduate Study Type of resource Text File origin Born digital Access conditions Open access Terms of use Created on 2017-05-25 09:22:17
