The significance of atherosclerotic changes in the endothelium of extracranial arteries in patients with atrial fibrillation and cerebral stroke
DOI: https://doi.org/10.29296/25877305-2020-09-12
Issue:
9
Year:
2020
Objective: to investigate the significance of atherosclerotic changes in the endothelium of
extracranial arteries in patients with atrial fibrillation (AF) and cerebral stroke (CS). Subjects and
methods. The investigation was conducted using the results of examinations in 126 patients who had been
treated in the Clinic of Nervous Diseases and Hospital Therapy. Results and discussion. The results of
carotid artery (CA) ultrasound were used to form two groups: 1) patients without endothelial changes; 2)
those with CA atherosclerosis. In Group 2, the National Institutes of Health Stroke Scale (HIHSS) scale
scores for the severity of neurological symptoms was 15, which corresponded to severe neurological
disorders; Group 1 more frequently showed moderate disorders (12 scores). The presented groups were
comparable in terms of nutrition, smoking, and a history of hypertension, lower extremity atherosclerosis
obliterans, and CS. Group 2 patients displayed left ventricular hypokinesia/akinesia (55.3 versus 33.3%;
χ2=2.6; p=0.03) and intracardiac thrombosis (p>0.05). Conclusion. In patients with extracranial
atherosclerosis and obvious heart rhythm disturbance, the risk for CS is 4–5 times higher than in those with
AF and little altered CAs. In the former, CS is more commonly accompanied by severe neurological disorders
and disability. In order to prevent cardioembolic and atherothrombotic complications, the patients with AF
must undergo CA duplex scanning and, if atherosclerotic plaques are present, take anticoagulants and
statins.
Keywords:
cardiology
atrial fibrillation
carotid artery atherosclerotic changes
risk stratification
duplex scanning
intima-media complex
acute cerebrovascular accident
hypertension
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