[The status of large vessels in overweight and obesity according to ultrasound findings]. / Sostoyanie krupnykh sosudov pri izbytochnoi masse tela i ozhirenii po dannym ul'trazvukovogo issledovaniya.

AIM: To investigate the impact of overweight and obesity on the structure and function of large arteries in apparently healthy individuals; to estimate the magnitude of atherosclerotic lesions of the vessels. MATERIALS AND METHODS: Sixty-one apparently healthy individuals with varying weights were randomly examined. All the examinees were divided into 3 groups according to their body mass index (BMI) and blood pressure (BP). They all underwent ultrasonography of the brachiocephalic arteries at the extracranial level, as well as the abdominal aorta and femoral arteries. RESULTS: The overweight and obese persons have increased diameters and thickness of the intima-media complex of the common carotid arteries and aorta. These changes are maximally pronounced in obesity in conjunction with high normal BP (systolic BP, 130-139 mm Hg; diastolic BP, 85-89 mm Hg). At the same time, there is a reduction in blood flow velocities and an increase in arterial wall stiffness. More marked structural and functional changes are observed in persons with abdominal obesity. The femoral artery belonging to muscular ones exhibited no structural changes, but displayed reduced blood flow velocities in obesity concurrent with high normal BP. In all the groups, the spread of atherosclerotic plaques is equal; the latter are recorded in one third of the examinees. However, the degree and incidence of vascular atherosclerosis are higher in overweight and obesity concurrent with high normal BP. CONCLUSION: The overweight and obese persons without cardiovascular diseases were found to have eccentric remodeling of elastic and muscular-and-elastic vessels: the carotid arteries and aorta in conjunction with increased intima-media thickness, reduced blood flow velocities, and atherosclerotic vascular changes. These changes are most pronounced in the obese persons with high normal BP. In all the groups, atherosclerotic changes are encountered mainly in the brachiocephalic arteries at the extracranial level.

[Time course of changes in brachial artery function in patients with unstable angina pectoris during perindopril therapy].

AIM: To estimate the time course of changes in brachial artery (BA) functional parameters in patients with unstable angina (UA) treated with angiotensin-converting enzyme inhibitors. SUBJECTS AND METHODS: After examination, 30 patients with Braunwald Classes IB and IIB UA were randomized to two groups to receive perindopril or enalapril as part of combination therapy (Group 1 and Group 2, respectively). The authors carried out BA duplex scanning with a reactive hyperemia test, calculated the values of its viscoelastic properties, and determined pulse wave velocity (PWV) at baseline and after 3 months. RESULTS: The patients of both groups did not differ in BA functional parameters at baseline. Following 3 months, Group 1 showed a reduction in Young's (p = 0.046) and Peterson's (p = 0.049) modules, an increase in compliance (p = 0.016) and distensibility (p = 0.02) coefficients, and a decrease in PWV (p = 0.23). Estimation of endothelium-dependent vasodilation of BA revealed a significant increase in its diameter increment both at testing minutes 1 (p = 0.047) and 2 (p = 0.049). In Group 2, only did the distensibility coefficient change significantly (p = 0.041). After the reactive hyperemia test, there was a significant rise in BA diameter increment at minute 1 (p = 0.047) and no change in this indicator at minute 2. CONCLUSION: After 3-month treatment, the viscoelastic properties of BA improved in all indicators in the patients taking perindopril as part of combination therapy. The use of enalapril improved only an arterial distensibility index. The BA endothelial function estimated by its diameter increment also displayed better changes in the patients receiving perindopril.