EARLY CAROTID ARTERY REMODELING AND FUNCTIONAL VIOLATIONS OF INTRACARDIAC HEMODYNAMICS WITH MULTIFOCAL ATHEROSCLEROSIS

Objective of the work is a one-center study of the features of carotid artery remodeling and functional disturbances of intracardiac hemodynamics in patients with multifocal atherosclerosis (MFA) under conditions of the Regional Vascular Center No. 1 in Ufa.Depending on the vascular lesion, patients were divided into 3 clusters according to the clinical manifestation of atherosclerotic lesions of the heart, brain and arteries of the lower limbs by the method of hierarchical analysis of categorical variables. 131 of themhad MFA with primary heart damage (1st cluster), 87 with MFA with predominance of carotid lesions (2nd cluster), and 29 patientswith lower limb ischemia (3rd cluster). All patients underwent clinical assessment, ECG, coronary angiography, echodopleroscopy of the carotid and arteries of the lower limbs. According to the indications, magnetic resonance imaging of the thorax and abdominal organs, ultrasound of the abdominal cavity and kidneys were made, and ultrasound of the pelvis, if necessary, was carried out.We found that:The 1st cluster is accompanied by the growth of stage III AH in combination with unstable angina, a history of myocardial infarction (MI), associated with stenotic carotid artery disease, left atrial dilatation, and left ventricular diastolic dysfunction of type 2; The second cluster with acute and chronic ischemic impairment of cerebral circulation also predominantly occurred with the presence of Stage III AH, which was combined with stable angina of 2nd FC and left ventricular hypertrophy, with stenosing carotid artery lesions among them being less often detected and the significance Stenosis was lower, but 25% of the patients showed an in-crease in carotid CTM of 1.3 mm or more, which was regarded as a sign of atherosclerotic carotid artery disease;The 3rd cluster with hemodynamic ischemia with clinical manifestation of vascular lesion of the lower extremities revealed prevalence of grade II AH, stable angina with PK2, early onset of CEH without a previous history of stroke, with intermittent claudication, which was combined mainly with the growth of atherosclerotic plaques, diastolic dysfunction Type 1, dilatation of the ascending aorta and hypertrophy of the interventricular septum.The mutual influence of the comorbid background in MFA changes their clinical picture, the nature of the course, increases the number of complications associated with the development of remodeling of the main arteries and violations of intracardiac hemodynamics.

мультифокальный атеросклероз, коморбидность, ремоделирование сонных артерий, функциональные нарушения внутрисердечной гемодинамики, multifocal atherosclerosis, comorbidity, remodeling of carotid arteries, functional disturbances of intracardiac he-modynamics

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