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The journal "Ateroskleroz"

2018 year, number 1


V.V. Genkel, A.O. Salashenko, L.R. Toropova, V.A. Sumerkina, I.I. Shaposhnik
South Ural State Medical University of Minzdrav of Russia, 454092, Chelyabinsk, Vorovskogo, 64
Keywords: эндотелий-зависимая вазодилатация, ишемическая болезнь сердца, сахарный диабет, атеросклероз периферических артерий, flow-mediated dilation, coronary artery disease, diabetes mellitus, peripheral arterial disease


Aim. To study flow-mediated dilation (FMD) in patients with coronary artery disease (CAD), depending on the presence of diabetes mellitus (DM) type 2. Materials and Methods. The study included 137 patients (77 men and 60 women) with CAD. The average age of patients was 62.0 (57.0-66.0) years. The first group included 67 patients with CAD and DM type 2 and the second group included 70 patients with CAD. All patients underwent duplex scanning of the carotid and lower limb arteries. FMD was evaluated in a test with reactive hyperemia according to D.S. Celermajer in the modification of O.V. Ivanova. Results. The dilated response of the brachial artery was statistically significantly less in the first group of patients - 5.20 % (3.57-7.14) vs. 9.30 % (4.61-12.0) in the second group ( p = 0.0001). In the group of patients with DM, the proportion of patients with a dilated response less than 10 % was 61 (91.0 %), which was significantly less in comparison with the second group - 40 (57.1 %) patients ( p = 0.0001) . A decrease in the dilatational response of the brachial artery was associated with an increase in the degree of stenosis of the left CCA ( r = -0.286, p = 0.001), overall carotid stenosis ( r = -0.186; p = 0.029), plaque score (r = -0.279; p = 0.001), total carotid plaque area ( r = -0.256; p = 0.003); increase in femoral IMT ( r = -0.246; p = 0.004). The magnitude of the dilated response of the brachial artery during reactive hyperemia was inversely correlated with the duration of DM type 2 ( r = -0.349, p = 0.0001) and glycated hemoglobin ( r = -0.308; p = 0.0001). Conclusion. Patients with CAD and DM type 2 showed statistically significantly lower values of FMD compared with patients with CAD without DM. Decrease in FMD was associated with the severity of the DM type 2 and the severity of subclinical atherosclerosis of peripheral arteries.