METHOD OF VOLUMETRIC SPHYGMOGRAPHY IN THE DIAGNOSIS OF EARLY VASCULAR AGING IN PATIENTS WITH SUBCLINICAL HYPOTHYROIDISM

Secondary dyslipidemia, oxidative stress, endothelial dysfunction and inflammatory reaction in the vascular wall that develop in subclinical hypothyroidism (SH) are among the factors that accelerate vascular aging. It is known that vascular aging is associated with a decrease in elastin content and an increase in collagen in the vascular wall, which leads to arterial wall rigidity, a decrease in the damping function of arteries, mainly the aorta, and, ultimately, to impaired organ and tissue perfusion. At the same time, the pulse wave velocity increases, which is used in the clinic as a parameter for determining vascular wall rigidity.
The purpose of the study: to assess vascular age and the capabilities of volumetric sphygmography (OS) in diagnosing early vascular aging in working-age patients with SH.
Materials and methods. The analysis included clinical and instrumental data of 70 patients who considered themselves healthy and had thyroid pathology diagnosed for the first time during a medical examination: 46 with SH (10.9 % (n = 5) of men and 89.1 % (n = 41) of women) and 24 patients without thyroid dysfunction (16.7 % (n = 4) of men and 83.3 % (n = 20) of women). The formed groups were comparable by gender, age, smoking status, presence of lipid metabolism disorders and arterial hypertension. The passport age was 53.2 ± 4.01 years and 51.8 ± 5.11 years, respectively (p > 0.05). In order to determine the vascular age, a calculation approach was chosen using the ASCORE scale and visualization techniques: volumetric sphygmography (OS) and ultrasound examination of the carotid arteries. Study design: cross-sectional cohort.
Results. According to the ASCORE scale, the proportion of individuals with early vascular aging was 80.4 % (n = 37) versus 58.3 % (n = 14) (χ 2 = 3.90; p < 0.05). A direct, moderate-strength relationship was established between laboratory-confirmed vascular aging and the presence of signs of atherosclerotic (r = 0.49; p < 0.05), multivessel lesions of the carotid arteries (r = 0.43; p < 0.05); between early vascular aging according to the ASCORE scale and ultrasound signs of early vascular aging (r = 0.33, p < 0.05), a reduced ankle-brachial index (ABI) value on one of the legs and the presence of ultrasound signs of multivessel atherosclerotic lesions of the carotid arteries (r = 0.337, p < 0.001), signs of ASP instability (r = 0.43; p < 0.05). At the same time, according to CAVI, there was no reliable intergroup difference, statistically significant evidence in favor of early vascular aging in patients with HS: R-CAVI was 8.0 (6.47–9.2) and 7.7 (6.5–8.3), L-CAVI – 7.6 (6.7–8.9) and 7.3 (6.2–8.3), respectively.
Conclusion. The relationships we have established between early vascular aging according to the ASCORE scale and ultrasound signs of early vascular aging, a reduced ABI value at least on one of the legs and the presence of ultrasound signs of polyvascular atherosclerotic lesions of the carotid arteries, signs of ASP instability indicate the inadmissibility of the isolated use of the cardio-ankle index CAVI in the diagnosis of early vascular aging in comorbid patients. In the case of a tandem analysis of the main characteristics of vascular wall stiffness (CAVI and ABI) and clarification of additional indices of volumetric sphygmography, the diagnostic value of the method increases.

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