DOPPLER ULTRASOUND CHANGES IN INTERNAL CAROTID ARTERY IN ISCHEMIC HEART DISEASE AND CEREBRAL ISCHEMIC STROKE
Vakulenko I.P., Jemai Ahmed, Shuljenko A.I., Vinnikov S.Y
National medical university M.Gorky of Donetsk
Introduction. Internal carotid lesions are the leading causes of cerebral vascular accident, setting evidence and quantification of these lesions have been based for a long time on arteriography, which presents many methodological difficulties, which led to propose other methods quantifications, including the Doppler ultrasound that remains the only non-invasive method of exploration. The state of cardiac function, if with the cerebral vascular accident is associated a cardiac ischemia, should be taken into consideration in the treatment of so the interest of the echocardiography in this kind of situation.
Aim. Prospectively Studying the influence of cerebral ischemic stroke and ischemic heart disease on blood flow in internal carotid arteries.
Materials and methods. We examined 60 patients with cerebral ischemic stroke and ischemic heart disease by color duplex sonography, aged from 27 to 84 years (average age 65.95 ±10.6 years), and 30 healthy subjects, aged from 18 to 62 years (average age 52.30 ±7.5 years). The study was realized by the device "ACUSON X300" (Siemens, Germany) using linear transducer in B-mode and Doppler color flow mapping. Measured peak systolic velocity (PSV), end-diastolic velocity (EDV), time average maximum velocity (TAMX), time average velocity (TAV), peak early diastolic left ventricle filling velocity/peak atrial filling velocity ratio (E/A M), left ventricular ejection fraction (LVEF) and stroke volume (SV). The analyze of the results of study using statistical packages «Med Stat» (Lyakh YE, Guryanov VG, 2004-2012) and Statistica Neural Networks (Stat Soft Inc., 1999).
Results. In the exploration of the internal carotid arteries we found these values of PSV = 110±15,3 cm/s, EDV= 48±10,5 cm/s, TAMX = 69±7,4 cm/s and TAV = 35± 8,1 cm/s in patients with cerebral ischemic stroke and ischemic heart disease were respectively higher than those measured in healthy subjects: PSV = 61±5,3 cm/s, EDV = 20±9,5 cm/s, TAMX = 30±4,5 cm/s and TAV = 20 ±6,9 cm/s with high coefficient of correlation (r = 0.74-0.89; p = 0.001). In the heart exploration 80% of patient have diastolic dysfunction E/A M = 0.87±0,1 highrely correlated with the presence of cerebral ischemic stroke and ischemic heart disease (r = 0.62; p = 0.001) and 10% with systolic dysfunction LVEF = 50%±5,2, and SV = 95ml±7,1 but with moderate correlation (r = 0.43; p > 0.05).
Conclusion. The study showed that patients with cerebral ischemic stroke and ischemic heart disease have more severe blood flow changes in internal carotid arteries because of the most frequent atheromatous damage that affects these arteries.