Features of vascular remodelling in the patients with arterial hypertension in a case of brain stroke

Authors

  • I. V. Drozdova State Institution " Ukrainian State Institute of Medical and Social Problems of Disability Ministry of Public Health of Ukraine», Dnipro, Ukraine,

DOI:

https://doi.org/10.14739/2310-1210.2017.5.110089

Keywords:

stroke, hypertension, atherosclerosis

Abstract

Purpose of research – to determine the features and factors which influence the vascular remodelling in patients with arterial hypertension in the late restoration period of brain stroke, taking into account an intima-media complex thickness.

Materials and methods. The research enrolled 44 patients with stage III AH in the restoration period of a brain stroke. All participants underwent ultrasound examination of the brachycephalus arteries, daily monitoring of arterial pressure, Doppler echocardiography. Patients were divided into 2 groups: the I group included 24 patients (54.5 %) with normal thickness of complex intima-media (CIM), the II group – 20 (45.5 %) patients with thickness of CIM >0.9 mm.

Results. In the patients with stage III AH in a case of brain stroke thickening of CIM was in 45.5 %, concentric hypertrophy – in 25.0 % and remodelling – in 10.0 %. Daily profiles of AP such as night-peaker were observed in 20.0 % of patients, an over-dipper – in 5.0 %, which indicated an unfavourable prognosis regarding repeated cases of the cardiovascular events. Structural and functional features in the vessels of patients with stage III AH were formed under an influence of both diastolic and systolic dysfunction of LV, hypertrophy and concentric remodelling, presence, duration and an inadequate treatment of AH, anthropometric and other risk factors in the patients with AH in the restoration period of a brain stroke, which requires a rigorous tactic of their correction.

Conclusions. Determination of the factors affecting structural and functional peculiarities of vessels in the patients with AH, together with commonly accepted risk factors, should be on a basis to assess their rehabilitation potential, stratification of a common cardiovascular risk, development of an individual rehabilitation program for disabled people with this pathology. Further, the role, character, prognosis and effectiveness of the revealed features correction in the patients with arterial hypertension in the restoration period of a brain stroke should be clarified.

References

Аjvazyan, S. A., Bezhaeva, Z. I., & Staroverov, O. V. (1974). Klassificaciya mnogomernykh nablyudenij [Classification of multidimensional supervisions]. Moscow: Statistica. [in Russian].

Babak, V. P., Biletskyi, A. Ya., Prystavka, O. P., & Prystavka, P. O. (2001). Statystychna obrobka dannykh [Statistical processing of data]. Кyiv: МВВTS [in Ukrainan].

Vayda, L. S., Lozinska, N. V., Habriel, M. V., & Gay, О. I. (2015). Pokaznyky dobovoho monitoruvannia arterialnoho tysku, lipidnoho spektra krovi, vazodylatatorna funktsiia endoteliiu ta indeks masy tila u khvorykh na arterialnu hipertenziiu na tli likuvannia karvedylolom i atenololom [The parameters of the 24 hours blood pressure monitoring, blood lipid spectrum, endothelial vasodilator function and body mass index in patients with arterial hypertension under treatment with carvedilol and atenolol]. Ukrainskyi kardiolohichnyi zhurnal, 4, 55–60. [in Ukrainian].

Dolzhenko, M. М., Grubyak, L. M., & Sokhor, N. R. (2016). Morfofunktsionalnyi stan ekstrakranialnykh arterii u khvorykh na arterialnu hipertenziiu pislia perenesenoho ishemichnoho insultu [Morphological and functional extracranial arteries changes in hypertensive patients after ischemic stroke]. Ukrainskyi kardiolohichnyi zhurnal, 5, 44–49. [in Ukrainian].

Dican, I. N. (2013). Vozrastnye osobennosti izmenenij kompleksa intima-media obschikh sonnykh arterij v period reabilitacii posle perenesennogo ishemicheskogo insul´ta [Age-dependent features of changes of complex of intima-media of general carotids in the period of rehabilitation after the carried ischemic stroke]. Problemy stareniya i dolgoletiya, 3, 294–300. [in Russian].

Kovalenko, V. M., Nesukay, Е. G., Polenova, N. S., Titov, E. Yu., & Danylenko, O. O. (2014). Vzaiemozv’iazok mizh strukturno-funktsionalnym stanom livykh viddiliv sertsia i tolerantnistiu do fizychnoho navantazhennia v patsiientiv z hipertonichnoiu khvoroboiu [Relationship of structural and functional state of left heart to exercise tolerance in patients with essential hypertension]. Ukrainskyi kardiolohichnyi zhurnal, 4, 26–32. [in Ukrainian].

Kovalenko, V. M., Nesukay, E. G., Titov, E. Yu., Polenova, N. S., & Danylenko, O. O. (2014). Osoblyvosti strukturno-funktsionalnoho stanu livykh viddiliv sertsia u patsiientiv z hipertonichnoiu khvoroboiu z riznymy typamy remodeliuvannia [Features of structural and functional state of the left heart in hypertensive patients with different types of remodeling]. Ukrainskyi kardiolohichnyi zhurnal, 5, 44–49. [in Ukrainian].

Lisova, O. O. (2015) Diahnostychni ta prohnostychni znachennia parametriv rekonstruktsii sertsevo-sudynnoi systemy u patsiientiv z arterialnoiu hipertenziieiu ta ishemichnym insultom (Avtoref. dis… dokt. med. nauk) [Diagnostic and prognostic value of cardiac and vascular remodeling in hypertensive patients after ischemic stroke. Dr. med. sci. diss.]. Dnipropetrovsk. [in Ukrainan].

Melnikova, L. V. (2009). Structurno-funkcional´nye osobennosti obschikh sonnyhk arterij u bol´nykh e´ssencial´noj gipertenziej v zavisimostj ot velichiny sistolicheskogo arterial´nogo davleniya [The dependency of structural and functional features of common carotid arteries on systolic blood pressure in hypertensive patients]. Arterial´naya gipertenziya, 5, 51–54. [in Russian].

Michenko, T. S., & Pesotskaya, E. V. (2004) Sostoyanie magistral´nykh sosudov golov i shei u bol´nykh, pereneshikh aterotromboticheskij insul´t [State of main vessels of head and neck for patients carrying an ischemic stroke]. Current issues in pharmacy and medicine: science and practice, 67, 128–132. [in Russian].

Michenko, T. S., & Pesockaya, E. V. (2007) Utolscheniye kompleksa intima-media vnutrennej sonnoj arterii kak predictor ishemicheskogo insul´ta [Bulge of complex of intima-media of internal carotid as predictor of ischemic stroke]. Praktychna anhiolohiia, 6(11), 28–37. [in Russian].

Syvolap, V. D., Lashkul, D. A., & Zemlyanoy, Ya. V. (2010). Kardial´noe remodelirovanie i diastolisheskaya funkciya u bol´nykh ishemischeskoj bolezn´yu serdca s arterial´noj gipertenziej [Cardiac remodeling and diastolic function in patient with ischemic heart disease and arterial hypertension]. Suchasni medychni tekhnolohii, 3(7), 26–31. [in Russian].

Berezin, A. E., & Lisovaya, O. A. (2014). Predicted Value of Serial Measurments of Circulating Vascular Endothelial Growth Factor-1 in Arterial Hypertension Patients after Acute Ischaemic stroke. Cardiovascular Medicine, 17(1), 14–20. doi: 10.4414/cvm.2014.00205.

Mancia, G., Fagard, R., Narkiewicz, K., Redon, J., Zanchetti, A., Böhm, M., et al. (2013) ESH/ESC guidelines for the management of arterial hypertension: the Task Force for the Management of Arterial Hypertension of the European Society of Hypertension (ESH) and of the European Society of Cardiology (ESC). Eur. Heart. J., 34(28), 2159–2219. doi: 10.1093/eurheartj/eht151.

Parati, G., Stergiou, G., O’Brien, E., Asmar, R., Beilin, L., Bilo, G., et al. (2014). European Society of Hypertension practice guidelines for ambulatory blood pressure monitoring. J. Hypertens., 32, 1359–1366. doi: 10.1097/HJH.0000000000000221.

Tendera, M., Aboyans, V., Bartelink, M. L., Baumgartner, I., Clément, D., Collet, J. P., et al. (2011) ESC Guidelines on the diagnosis and treatment of peripheral artery diseases: Document covering atherosclerotic disease of extracranial carotid and vertebral? Mesenteric, renal, upper and lower extremity arteries: the Task Force on the Diagnosis and Treatment of Peripheral Artery Diseases of the European Society of Cardiology (ESC). Eur. Heart. J., 32(22), 2851–2906. doi: 10.1093/eurheartj/ehr211.

Zhang, Yi., Leong, H., Kretz, S., Agnoletti, D., Mourad, J. J., Safar, M. E., & Blacher, J. (2013). Characteristics and Future Cardiovascular Risk of Patients With Not-At-Goal Hypertension in General Practice in France: The AVANT’AGE Study. J. Clin. Hypertens., 15, 291–295. doi: 10.1111/jch.12082.

Downloads

How to Cite

1.
Drozdova IV. Features of vascular remodelling in the patients with arterial hypertension in a case of brain stroke. Zaporozhye Medical Journal [Internet]. 2017Oct.17 [cited 2024Dec.27];(5). Available from: http://zmj.zsmu.edu.ua/article/view/110089

Issue

Section

Original research