Stress test with physical activity: features of hemodynamics and kinetics of carotid arteries in atherosclerotic stenosis
https://doi.org/10.15829/1560-4071-2023-5286
EDN: MQXSBM
Abstract
Aim. To analyze the effect of exercise on cerebral hemodynamics in borderline stenosis of internal carotid artery (ICA) (40-69%) in asymptomatic patients.
Material and methods. The study included 120 patients: group I (n=40) — without signs of carotid bifurcation atherosclerosis; II (40) — with hemodynamically insignificant stenosis of ICA (40-69%): IIA — with ICA stenosis of 40-59% (18); IIB — 60-69% (22); III (40) — with hemodynamically significant stenosis of ICA (≥70%, without occlusion). All patients underwent following investigations: blood coagulation and lipid profile tests; doppler ultrasound of extracranial vessels, sphygmography of the common carotid artery (CCA), brain computed tomography, transcranial doppler ultrasound, cycle ergometer stress echocardiography with determination of ICA stenosis hemodynamics.
Results. In most (29 (72,5%)) patients of group II, stress test revealed a decrease in ICA flow, CCA kinetics according to sphygmography compared with group I, as well as a direct correlation between the degree of stenosis and a blood flow decrease. The indicators approached the data of group III patients.
Conclusion. With stenosis of the ICA (40-69%), when a submaximal heart rate (HR) is reached, a functional hemodynamically significant stenosis of the ICA develops. An additional indication for carotid endarterectomy is a combination of 40-69% stenosis and functional hemodynamically significant stenosis when submaximal heart rate is reached. Patients with ICA stenosis (40-69%) require a stress test to assess functional hemodynamically significant stenosis when submaximal heart rate is reached.
About the Authors
M. A. Fedorina
Samara State Medical University
Russian Federation
Competing Interests:
Russian Federation
Marina A. Fedorina - Leading Specialist International Scientific and Educational Center for Cardiovascular Pathology and Cardioimaging.
Samara
Competing Interests:
Conflict of interest not declared.
I. L. Davydkin
Samara State Medical University
Russian Federation
Competing Interests:
Russian Federation
Igor L. Davydkin - Vice-Rector for Research and Innovation, Head of the Department of Hospital Therapy with a Course of Polyclinic Therapy and Transfusiology, Professor, MD.
Samara
Competing Interests:
Conflict of interest not declared.
O. A. Germanova
Samara State Medical University
Russian Federation
Competing Interests:
Russian Federation
Olga A Germanova - Director International Scientific and Educational Center for Cardiovascular Pathology and Cardioimaging,docent, PHD.
Samara
Competing Interests:
Conflict of interest not declared
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For citations:
Fedorina M.A., Davydkin I.L., Germanova O.A. Stress test with physical activity: features of hemodynamics and kinetics of carotid arteries in atherosclerotic stenosis. Russian Journal of Cardiology. 2023;28(6):5286. (In Russ.) https://doi.org/10.15829/1560-4071-2023-5286. EDN: MQXSBM
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