Morpho-hemodynamic asymmetries in patients with arterial hypertension and their possible role in the pathogenesis of hypertensive disease
https://doi.org/10.34680/2076-8052.2021.3(124).112-116
Abstract
To evaluate the prospects of duplex Doppler ultrasound for studying morphofunctional features of vertebral arteries, we investigated duplex Doppler ultrasound scanning of vertebral arteries in 279 patients with stages 1–2 arterial hypertension (149 patients with stage 1 hypertension and 130 patients with stage 2 hypertension). The control group included 196 subjects with normal blood pressure values. Duplex Doppler ultrasound included the following hemodynamic parameters of vertebral arteries: peak systolic velocity, pulsatility index, resistance index, and also the asymmetry of vertebral arteries diameters — the ratio of the diameter of the left vertebral artery to the diameter of the right vertebral artery; volumetric blood flow. The reactivity of the vertebral arteries was studied by assessing the response of hemodynamic parameters to head rotation. The severity of muscle sleeve fibrosis surrounding the vertebral arteries in the C5–C6 segments of the cervical spine was evaluated at 4 degrees (from 0 to 3). The study found differences in the morphology of the vertebral arteries as well as the ultrasound parameters of the muscle sleeve surrounding the vertebral arteries in the C5–C6 segments but the greatest differences were observed precisely in the indicator of the reactivity of the vertebral arteries on head rotation. Reactivity indicators were expressed as changes in the parameters of pulsatility index and resistance index. The results of the study showed that early changes in the muscle sleeve surrounding the vertebral arteries in the C5–C6 segments lead to changes in the diameters of the vertebral arteries and their reactivity during further traumatization of vessels and sympathetic fibers caused by rotation of the head. Reactive indicators express to a far greater degree on the left vertebral artery and their progression increase with the progression of hypertension occurred.
About the Authors
Yu. G. Gaevsky
Новгородский государственный университет имени Ярослава Мудрого
Russian Federation
Russian Federation
V. R. Veber
Новгородский государственный университет имени Ярослава Мудрого
Russian Federation
Russian Federation
V. M. Zakharova
Новгородский государственный университет имени Ярослава Мудрого
Russian Federation
Russian Federation
References
1. Lawes C.M., Vander H.S., Rodgers A. Global burden of blood-pressure-related disease, 2001. Lancet, 2008, Vol.371, No.9623, pp.1513-1518.
2. Egan M.B. The prevalence and control of hypertension in adults. Available at: https://www.uptodate.com/contents/theprevalence-and-control-of-hypertension-in-adults (accessed: 08.05.2021).
3. Chazova I.E., Oshchepkova E.V., Zhernakova Yu.V. Arterial’naya gipertoniya u vzroslyh [Arterial hypertension in adults]. Moscow, Rossiyskoe meditsinskoe obshchestvo po arterial'noy gipertonii Publ., 2016, 70 р.
4. Robinson J., Kothari M.J. Clinical features and diagnosis of cervical radiculopathy. Available at: https://www.uptodate.com/contents/clinical-features-and-diagnosis-of-cervicalradiculopathy (accessed: 08.05.2021).
5. Bijlsma J.W.J., Berenbaum F., Lafeber F.P.J.G. Osteoarthritis: An update with relevance for clinical practice. The Lancet, 2011, no.9783 (377), pp.2115–2126.
6. Doherty M. Clinical manifestations and diagnosis of osteoarthritis. Available at: https://www.uptodate.com/contents/clinicalmanifestations-and-diagnosis-of-osteoarthritis (accessed: 08.05.2021).
7. Gaevskiy Yu.G., Filina E.V., Krasnikova O.P. Dupleksnoe issledovanie pozvonochnykh arteriy u bol'nykh s arterial'noy gipertenziey [Duplex study of vertebral arteries in patients with arterial hypertension]. Rossiyskiy meditsinskiy zhurnal, 2010, no.2, pp.9–14.
8. Gaevskiy Yu.G., Kopina M.N., Chuvakov G.I. Lokal'nyy fibroz sheynykh mezhpozvonkovykh myshts i ego svyaz' s diametrom i krovotokom pozvonochnykh arteriy u zdorovykh i bol'nykh arterial'noy gipertoniey [The local fibrosis of cervical intervertebral muscles and its relationship with diameter and blood flow of vertebral arteries in healthy and ill patients with arterial hypertension]. Rossiyskiy meditsinskiy zhurnal, 2013, no.1, pp.28–30.
9. Gaevskiy Yu.G., Zakharova V.M., Yarosvet I.V. Morfogemodinamicheskie markery pozvonochnykh arteriy u patsientov arterial'noy gipertenziey [Morphogemodynamic markers of vertebral arteries in patients with arterial hypertension]. Vestnik NovSU, 2018, no.2, pp.36–38.
10. Gaevskiy Yu.G., Veber V.R., Zakharova V.M., et al. Ul'trazvukovye osobennosti morfologii vtorogo segmenta pozvonochnykh arteriy i ikh gemodiamiki u zdorovykh lits i u patsientov s razlichnymi stadiyami arterial'noy gipertenzii [Some of the ultrasound features of the second segment of the vertebral arteries and their hemodynamics parameters in healthy persons and in patients with different stages of arterial hypertension]. Diagnostic radiology and radiotherapy, 2019, vol.1, pp.33-38. DOI: https://doi.org/10.22328/2079-5343-2019-10-1-33-38
11. Gaevskiy Yu.G., Kopina M.N., Zakharova V.M. Rol' dupleksnogo issledovaniya pozvonochnykh arteriy v vyyasnenii prichin golovokruzheniy u bol'nykh s gipertonicheskoy bolezn'yu [The role of duplex study of vertebral arteries in identifying the causes of vertigo in patients with hypertension]. Coll. of papers “Aktual'nye problemy sovremennoy meditsiny” [Current problems of modern medicine], 2016, no.18, pp.103–111.
12. Gaevskiy Yu.G., Veber V.R., Zakharova V.M. Morfogemodinamicheskie osobennosti i vozmozhnaya rol' pozvonochnykh arteriy v patogeneze gipertonicheskoy bolezni [Morpho-hemodynamic features and the possible role of vertebral arteries in the pathogenesis of hypertension]. Proc. of “Aktual'nye voprosy fundamental'noy, klinicheskoy meditsiny i farmatsii” [Topical questions of fundamental, clinical medicine, and pharmacy]. Velikiy Novgorod, NovSU Publ., 2020, pp.20-25.
13. Kalashnikov V.I. Primenenie ul'trazvukovoy dopplerografii s funktsional'nymi nagruzkami v diagnostike i kontrole lecheniya sindroma pozvonochnoy arterii [Usage of Doppler ultrasonography with functional tests for diagnostics and treatment соntrol of the vertebral artery syndrome]. Mezhdunarodnyy nevrologicheskiy zhurnal, 2011, no.1 (39), pp.74- 78.
14. Safronova O.A., Nenarochnov S.V., Morozov V.V. Vozmozhnosti ul'trazvukovoy diagnostiki pri sindrome pozvonochnoy arterii [Possibilities of ultrasound diagnostics in vertebral artery syndrome]. Fundamental'nye issledovaniya, 2011, no.3 (10), pp.553–557.
15. Arterial'naya gipertenziya u vzroslykh. Klinicheskie rekomendatsii 2020 [Arterial hypertension in adults. 2020 Clinical guidelines]. Rossiyskiy kardiologicheskiy zhurnal, 2020, vol.25 (3), pp.149-218.
Review
For citations:
Gaevsky Yu.G., Veber V.R., Zakharova V.M. Morpho-hemodynamic asymmetries in patients with arterial hypertension and their possible role in the pathogenesis of hypertensive disease. Title in english. 2021;(3(124)):112-116. (In Russ.) https://doi.org/10.34680/2076-8052.2021.3(124).112-116
Views:
45
Email this article 