AIM:To study relationship between cardio-ankle vascular index (CAVI) and subclinical manifestations of noncoronary atherosclerosis in patients with stable ischemic heart disease (IHD).MATERIAL AND METHOD:We included into this study 511 patients with IHD examined within framework of a register of patients before aorto-coronary bypass surgery. CAVI was determined using VaSera-1000 device.RESULTS:We distinguished 2 groups of patients: (1) with abnormal (≥ 9.0, n = 128) and (2) normal (< 9.0, n = 383) CAVI. Group 1 compared with group 2 had high mean age (p = 0.02), comprised more women (p = 0.0016), hypertensive patients (p = 0.0061), patients with three vessel coronary disease, and patients with stenoses in carotid arteries. Multiple logistic regression analysis revealed independent association between elevated arterial stiffness and age. Elevated arterial stiffness was found in 25% of group 1 patients. Abnormal CAVI was associated with increased intima-media thickness and stenoses of carotid arteries but not with presence of stenoses in arteries of lower extremities.

Purpose. To investigate the prevalence of polyvascular disease (PolyVD) depending on the diagnosis criteria. Materials and methods. Seven hundred and thirty-two consecutive patients (586 men and 146 women), undergone CABG, were divided according to the number of affected arterial beds. The first definition of PolyVD was ≥ 30 % stenoses while the second one considered the lesions of ≥ 50 %. History, risk factors, laboratory and instrumental data were analyzed. Logistic regression was performed to reveal the influence of risk factors on the prevalence of PolyVD. Results. In the first definition of PolyVD (≥ 30 %) one-bed lesions were found in 385 (52,6 %) and two or more in 347 patients (47,4 %). In the second definition of PolyVD (≥ 50 %) one-bed lesions were found in 531 (72,5 %) and two or more in 201 patients (27,5 %). In the first definition of PolyVD the probability of its detection declined with the increase in BMI (p = 0,022) and GFR (p = 0,025), and rose with the history of hypertension (p < 0,001) and smoking (p = 0,005), older age (p < 0,001) and intima-media thickness (IMT) (p < 0,001). In the second definition of PolyVD the probability of its detection was higher with smoking (p = 0,001), the history of hypertension (p = 0,001) and older age (p = 0,001). This probability is reduced with the increase in BMI (p = 0,007). In a multivariate analysis, regardless of PolyVD definition, age (p = 0,001), IMT (p < 0,001), smoking (p = 0,002) and hypertension (p = 0,008) retained their influence on the probability of PolyVD detection. Conclusions. Before CABG PolyVD was diagnosed in 27,5 % of patients with ≥ 50 % stenoses and in 47,4 % of patients with ≥ 30 % stenoses. Risk factors associated with the prevalence of atherosclerosis are age, smoking, hypertension, IMT.

Aim. To study the relationship of cardiac-ankle vessel index (CAVI) and the results of coronary bypass grafting in CHD. Material and methods. 356 patients after CABG were selected into two groups according to CAVI: 1st group — CAVI≥9,0 (n=231), 2nd group — CAVI<9,0 (n=125). As end points after CABG in 1 year we used death, myocardial infarction (MI), acute cerebrovascular accident (CVA), transitory ischemic attack (TIA), rhythm disorders, polyorganic dysfunction syndrome development (PDS) and combination of these. Additionally the analysis performed to analyse the influence of various pre- and perioperational factors on the development of the endpoints. Results. In patients with normal CAVI there was more prevalent one-vessel diseases and bypass to one artery, compared to those with pathological CAVI. Groups did not show a significant difference in the quantity of shunts, duration of artificial circulation, and quantity of operations. It was revealed that the presence of pathological CAVI in CHD patients does negatively influence the short-term results of the operation. In these patients there were more perioperational complications of bypass grafting including strokes and deaths (p=0,05 and 0,02, resp.) Conclusion. In CHD patients pathological CAVI was found in 35% cases of coronary bypass grafting. CHD patients with higher CAVI were older, more often they had arterial hypertension, diabetes mellitus and lesions of no coronary arterial pools. Presence of pathological CAVI was associated with higher prevalence of perioperational complications of CABG, especially deaths and strokes perioperational complications of bypass grafting including strokes and deaths (p=0,05 and 0,02, resp.) Conclusion. In CHD patients pathological CAVI was found in 35% cases of coronary bypass grafting. CHD patients with higher CAVI were older, more often they had arterial hypertension, diabetes mellitus and lesions of no coronary arterial pools. Presence of pathological CAVI was associated with higher prevalence of perioperational complications of CABG, especially deaths and strokes.

The cerebral venous congestion is the primary factor in damaging the brain with cerebral venous thrombosis. Ischemia in stroke associated with cerebral venous sinusthrombosis (CVST) is secondary, developing as a result of externally induced constriction of the blood vessels feeding the area of stasis in vasogenic edema, which leads to necrosis is less likely than with arterial ischemic stroke. Stroke associating CVST more often accompanied by hemorrhagic transformation than atherothrombotic. Venous congestion is detected in cardioembolic stroke in the perifocal zone of the ischemic focus, and probably plays a role in the courses and outcomes of stroke, contributing to the development of vasogenic edema and early secondary hemorrhage. Identify venous stasis in principle possible using the technique of determining the ultrasound index arteriovenous ratio and sighting in the ischemic focus and perifocal zone as hyperperfusion using perfusion techniques MSCT or MRI of the brain.

Aim: to compare results of coronary angiography with data of multi-slice computed tomography (MSCT) - angiography, and analyze rate of detection of hemodynamically significant coronary artery lesions during preoperative examination of patients. Material and methods. We analyzed case histories of 92 patients (median age 59 years) examined prior to surgery on non-coronary vessels or for exclusion of ischemic heart disease. All patients were subjected to selective coronary angiography (CA) and MSCT - angiography. According to results of CA we formed 2 groups - with coronary artery stenoses >70% (n=55, group 1) and <70% (n=37, group 2). In 46 patients (50%) dobutamine stress echocardiography was performed for detection of concealed coronary insufficiency. Results. CA revealed hemodynamically significant stenoses >70% (>50% in left main coronary artery) in 91 of 324 arteries. MSCT angiography detected stenosis >50% in 184 of 324 arteries; in 148 patients results of MSCT were confirmed by presence of hemodynamically significant stenoses at coronary angiography (sensitivity 86%). Absence of lesions or presence of stenoses <50% were noted at MSCT in 368 arteries; in 345 cases this was confirmed by coronary angiography (predictive value of negative result 94%, specificity 91%). Result of dobutamine stress echocardiography was positive in 41% of patients in group 1 and in 20% - of group 2 (p < 0.001). Sensitivity of stress echocardiography for detection of significant stenoses was 41%, specificity - 80%, negative predictive value - 14%. Conclusion. Diagnostic value of MSCT for detection of coronary artery stenoses >70% have better sensitivity, specificity, negative and positive predictive value of compared with stress echocardiography. Results of this study confirm value of MSCT angiography for diagnosis of coronary atherosclerosis and allow to recommend it as a screening method for detection hemodynamically significant coronary artery involvement before extracardiac surgery.

Poster: ECR 2014 / C-0117 / Signs of routine CT and MRI in differential diagnostics of venous and arterial stroke’s genesis by: S. E. Semenov, A. A. Khromov, I. V. Moldavskaya, A. N. Khromova, E. A. Zhuchkova, M. G. Shatokhina; Kemerovo/RU

Purpose. The study was aimed at detecting the signs of focal and perifocal injury in venous strokes and their differences from those in arterial strokes by urgent CT and MRI. Materials and methods. The diagnosis of a venous stroke was verifi ed by neurovisualization (native MSCT, perfusion CT or CT angiography, conventional MRI and MR-angiography) and during autopsy (in case of a fatal outcome). Results. Patients with venous strokes had a hyperdense (by routine CT) stroke-related vessel, compensatory venous distention on the side of the occlusion, early haemorrhagic transformation, the changes localized in the region of the affected vein. Conclusions. The study allowed to detect CT and MRI signs, which can help to differentiate arterial and venous strokes.