M.М. Dolzhenko, L.M. Grubyak, N.R. Sokor. Morphological and functional extracranial arteries changes in hypertensive patients after ischemic stroke

The aim – to evaluate ECA morphological and functional features in hypertensive patients after ischemic stroke according to stroke and vascular departments’ experience.

Material and methods. We prospectively included 135 hypertensive patients without history of AF after ischemic stroke (IS) aged 36–78 years (61.0±9.1 years). All patients underwent Doppler Echo and duplex extra- and intracranial arteries sonography according to existing Guidelines with evaluation of common (CCA), external (ECA), internal carotid (ICA) and vertebral (VA) arteries.

Results. All hypertensive patients after IS regardless of IS substrate had significantly worse values of CCA IMC thickness vs. control group of healthy subjects. Significantly lower CCA diameter (Р<0.05), distensibility coefficient DC (Р<0.001) and higher stiffness index β (Р<0.005) vs. healthy subjects witness for progressive arterial remodeling in hypertensive patients after IS. Worse ECA remodeling indices according to stiffness index β showed significant high correlation with atherosclerosis progression according to CCA IMC thickness (r=0.87; p<0.0001). Hypertensive patients after IS vs. healthy subjects show significantly worse peripheral flow indices with higher peak systolic Vs (Р<0.001), and diastolic Vd (Р<0.001) and time-averaged TAMX CCA flow velocities ОСА (Р<0,001) with significantly lower resistance (RI) (Р<0.001) and Gorling’s pulsatile (PI) indices (Р<0.001). Conclusion. LV remodeling and systemic atherosclerosis progression in AH are parallel links of common pathogenetic chain, while their diagnosis should be synchronous in the patients with elevated cardiovascular risk for better primary and secondary prevention.

Full article