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The journal "Ateroskleroz"

2016 year, number 1

CLINICAL SIGNIFICANCE OF PATHOLOGICAL ANKLE-BRACHIAL INDEX IN PATIENTS WITH ACUTE ISCHEMIC STROKE

A. N. Sumin1, Iu. A. Kolmykova1, I. N. Kuhareva1, M. V. Ott1, D.A. Sumin1, N.I. Vodopiyanova1, A. A. Morkvenas1, O. A. Trubnikova1, A. V. Kovalenko1, B. M. Doronin2
1Multifocal Atherosclerosis of the Federal State Budgetary Institution Research Institute for Complex Issues of Cardiovascular Diseases, 650002, Kemerovo, Sosnovyi bulvar, 6, Russia
2Medical University, Russia, 630091, Novosibirsk, Krasnii prospect, 52
Keywords: лодыжечно-плечевой индекс, инсульт, неврологический статус, неврологические шкалы: NIHSS, Бартел, Ренкин, Эшворт, индекс мобильности Ривермид, ankle-brachial index (ABI), stroke, neurological status, neurological scale: NIHSS, Barthel, Rankin, Ashworth, mobility index Rivermid, MMSE

Abstract

Earlier research revealed that the decrease in ankle-brachial index (ABI) indicates the presence of atherosclerosis of the arteries of the lower extremities and increased risk of cardiovascular events, including stroke risk. Less studied is the relationship of ABI with clinical manifestations of stroke, the effect on recovery of neurological deficit. Therefore, the aim of the present study was to evaluate the relationship between pathological ABI and clinical outcomes of acute disorders of cerebral circulation (cerebral vascular accident) by the time of discharge from the hospital. Materials and Methods: The study included 375 patients after stroke. All patients underwent investigation of the state of the peripheral arteries using the device VaSera VS-1000 (Fukuda Denshi, Japan). Patients evaluated the presence of cardiovascular disease, previously vascular events, type and subtype of stroke. Also assessed neurological status with neurological scales: NIHSS, Barthel, Rankin, Ashworth, mobility index Rivermid and test swallowing. Cognitive function was assessed by Mini-Mental State Examination (MMSE). Results: In patients with abnormal ABI often identified ischemic stroke (99.4%). The study found that patients with abnormal levels of ABI (1.3 <ABI <0.9) often have concomitant cardiovascular disease. It was found that the speech disorders, central paresis of muscles of the face, tongue, and paresis of the extremities are more common in patients with a pathological ABI. In assessing the neurological deficit via neurological scales, patients with abnormal levels of ABI also showed poorer results on the scales MMSE, NIHSS, Barthel and Rankin. Conclusions: Pathological ABI values were detected in almost half of patients who have suffered acute violation of cerebral circulation. In patients with pathological ABI the restoration of disturbed functions runs worse compared with patients who had normal ABI. Also, this group of patients has a more pronounced cognitive impairment compared with the group with normal ABI.