Common carotid artery remodeling and left ventricular morphological changes in patients with essential hypertension combined with type II diabetes mellitus
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Abstract
The aim – to evaluate the signs of common carotid artery (CCA) and left ventricular (LV) remodeling in patients with essential hypertension combined with type II diabetes mellitus (DM II) according to the intima-media thickness (IMT), to conduct the correlation analysis between indexes of CCA and LV remodeling, level of blood pressure (BP), lipid and glycemic profiles.
Material and methods. We studied 39 patients: 1st group – 9 patients with IMT < 0.9 mm; 2nd – 18 patients with
IMT 0.9 < 1.3 mm, 3rd – 12 patients with IMT ≥1.3 mm. By using ultrasound duplex scanning we studied CCA remodeling, determined according to its diameter (dCCA), the ratio IMT/dCCA, arterial vascular segment mass (AM). By means of 2D-echocardiography we measured end-diastolic and end-systolic volume indexes (EDVI, ESVI), myocardial mass index (IMM), relative wall thickness, left ventricular ejection fraction, diastolic LV function; daily monitoring of blood pressure, study of blood glucose, HbA1c and lipid spectrum were also performed.
Results. LV eccentric hypertrophy was revealed in the 1st group patients. We observed CCA diameter increase, CCA eccentric hypertrophy, and LV eccentric hypertrophy in the 2nd group. IMM and EDVI were significantly greater in the 2nd then in the 1st group. In patients with hypertension and DM II at IMT 0.9 < 1.3 mm remodeling of heart and blood vessels has common features: eccentric hypertrophy signs in the CCA and LV, the presence of correlation between indicators of CCA and LV remodeling. Patients with hypertension and DM II at IMT ≥ 1.3 mm have mostly concentric LVH, severe degree of LV diastolic dysfunction, CCA eccentric hypertrophy, the largest percentage (75 %) individuals with CCA stenosis, relation to age, systolic blood pressure (SBP), SBP variability, lipid profile, glucose and indicators of CCA and LV remodeling.
Conclusion. In patients with hypertension combined with DM II, the definition of indicators of CCА remodeling (IMT, AM, IMT/dCCA) is important to influence risk factors and prevent complications, as well as to elaborate individualized medical approach.
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References
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