OBJECTIVE
To study the relationship between the parameters of the right heart and the thickness of the common carotid artery (CCA) intima-media complex (IMC) in patients with chronic cerebral ischemia (CCI).
MATERIAL AND METHODS
A single-center cross-sectional study analyzed clinical and instrumental data from 263 patients (137 males and 126 females) diagnosed with CCI. Depending on the average thickness of CCA IMC, patients were divided into two groups: Group 1 (n=184) with CCA IMC ≤1.3 mm and Group 2 (n=79) with CCA IMC ≥1.31 mm.
RESULTS
Patients in Group 2 were significantly older (64.7±10.8 years vs. 60.7±8.5 years for males; p<0.05) and had a higher rates of hypertension (64.5% vs. 40.2%; p<0.05), obesity (51.8% vs. 32.6%; p<0.05), chronic kidney disease (39.2% vs. 19.0%; p<0.05), a stable form of coronary heart disease (56.9% vs. 27.7%; p<0.05), hypercholesterolemia (49.3% vs. 35.8%; p<0.05), elevated levels of C-reactive protein (37.9% vs. 19.5%; p<0.05), and blood glucose (8.11±5.70 mmol/L vs. 6.26±2.4 mmol/L; p<0.05) compared to Group 1 patients. Parameters of the right heart, including right ventricular size (2.335±0.483 cm vs. 2.221±0.373 cm; p<0.05), thickness of the right ventricle anterior wall (0.437±0.104 cm vs. 0.396±0.079 cm; p<0.05), TAPSE (2.445±0.445 cm vs. 2.567±0.316 cm; p<0.05), pulmonary artery diameter (2.507±0.407 cm vs. 2.339±0.328 cm; p<0.05), and pulmonary artery pressure (38.4±16.1 mm Hg vs. 32.6±10.3 mm Hg; p<0.05) were significantly higher in Group 2. There were significant correlations between the average thickness of the CCA IMC and the size of the right ventricle (r=0.19; p<0.05), the thickness of the right ventricle anterior wall (r=0.21; p<0.05), the diameter of the pulmonary artery (r=0.22; p<0.05), and the systolic pressure in the pulmonary artery (r=0.20; p<0.05).
CONCLUSION
In patients with CCI, an increase in CCA IMC thickness ≥1.3 mm was associated with a higher rate of cardiovascular and metabolic risk factors, including hypertension, obesity, chronic kidney disease, stable coronary artery disease, hypercholesterolemia, elevated levels of C-reactive protein, and venous blood glucose. A significant correlation was established between the structural changes in the carotid arteries and the parameters of the right heart, which may reflect systemic atherosclerotic and hemodynamic changes that contribute to the progression of cerebrovascular disorders.
