Volume sphygmography in the diagnostics of preclinical stages of atherosclerosis in working-age patients with thyroid dysfunction

Serious clinical and population studies have revealed a close relationship between arterial elasticity indices and atherosclerotic damage to various vessels, the development of clinical complications, as well as a number of comorbid conditions that may affect atherogenesis. Thyroid pathology is often characterized by the development of cardiometabolic complications in the absence of previous symptoms.

Objective of the study: to evaluate the possibilities of the volume sphygmography in the diagnosis of preclinical stages of carotid atherosclerosis in patients of working age with thyroid dysfunction.

Materials and methods. Study design: cross-sectional cohort. Seventy healthy patients with newly diagnosed thyroid pathology were examined: 46 with subclinical hypothyroidism (SH) (thyroid stimulating hormone (TSH) level > 4.0 mIU/L with normal characteristics of free fractions of thyroid hormones) and 24 patients without thyroid dysfunction. We used methods of ultrasound examination of carotid arteries and volume sphygmography with assessment of the cardio-ankle vascular index (CAVI) and ankle-brachial index (ABI) in order to diagnose preclinical stages of atherosclerosis.

Results. In 69.6 % of patients with SН and 29.2 % of patients with normal thyroid function, vascular wall stiffness indices were different from normal and/or didn't correspond to the age norm (χ 2 = 10.43; p < 0.01). A direct relationship between a low ABI value in one of the legs and the presence of multivessel (2 or more) atherosclerotic lesions of the carotid arteries (r = 0.337, p < 0.001), signs of ASP instability (r = 0.43; p < 0.05) was established.

Conclusion. The obtained results indicate the development of polyvascular atherosclerosis with signs of instability of the atherosclerotic plaques in clinically healthy patients of working age with SH, compared to individuals without thyroid dysfunction. Untimely detection of preclinical stages of atherosclerosis entails untimely use of preventive drug and non-drug tactics, as a consequence – the development of atherosclerosis-associated complications, disability and mortality at a young age due to CSD. In order to promptly select the optimal diagnostic search, on the one hand – sufficient to identify asymptomatic stages of atherosclerosis of various localizations, on the other – safe for the doctor and the patient, economically accessible and easily performed in various regions of the Republic of Belarus, the volume sphygmography method can be recommended. The use of this non-invasive method for determining arterial wall damage in the diagnosis of atherosclerosis will increase the effectiveness of medical care for patients with CVD, which will lead to a decrease in the proportion of people with cardio- and cerebrovascular pathology in the Belarusian population.

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