Особенности диагностики мультифокального атеросклероза у пациентов умеренного и низкого риска и их рестратификация

В статье представлены современные представления о роли субклинического каротидного атеросклероза в качестве биомаркера и эквивалента ишемической болезни сердца. Отражены особенности выявления субклинического мультифокального атеросклероза у лиц умеренного и низкого риска. Это дает возможность проводить диагностику заболевания, верификацию диагноза, рестратификацию пациентов, идентификацию подгрупп лиц высокого и очень высокого риска и проводить комплекс лечебнопрофилактических мероприятий по агрессивной липидкоррегирующей фармакотерапии.

1. Rukovodstvo po aterosklerozu i ishemicheskoj bolezni serdca / pod red. E.I. Chazova, V.V. Kuharchuka, S.A. Bojcova. – M.: Media Medika, 2007.

2. Skvorcova V.I., Konstantinova E.I., Shurdumova M.H., Kol'cova E.A. Osobennosti ateroskleroticheskogo porazheniya v razlichnyh sosudistyh bassejnah // Klinicist. – 2008. – № 4. – S. 7–10.

3. Fuster V, Badimon JJ. Chesebro JН. Atherotгombosis mechanisms and clinical therapeutic approaches. Vasc Меа. 1998;3(3):231-9].

4. Evropejskie rekomendacii po diagnostike i lecheniyu zabolevanij perifericheskih arterij. 2011, 2016.

5. Nacional'nye rekomendacii po diagnostike i lecheniyu zabolevanij nizhnih konechnostej // Angiologiya u sosudistaya hirurgiya. – 2013. – № 2. – S. 5–67.

6. Lusis AJ. Atherosclerosis. Nature. 2000;407(6801):233–241.

7. Lekcii po serdechno-sosudistoj hirurgii / pod red. L.A. Bokeriya. – M.: NCSSH im. A.N. Bakuleva RAMN, 2013. – 764 s.

8. American Association of Clinical Endocrinologists and American College of Endocrinology Guidelines for Management of Dyslipidemia and Prevention of Cardiovascular Disease – Executive. Endocr Pract. 2017;23(4):479–97.

9. Kannеl WB. Risk fаctors for atherosclerotic сardiovascular outcomes in different arterial territories. J Саrdiovasc. Risk 1994; 1:333-9.

10. Mancia G, Fagard R, Narkiewicz K et al. 2013 ESH/ESC Guidelines for the management of arterial hypertension. European Heart Journal 2013;34:2159-219.

11. Barbarash L.S., Barbarash O.L., Malyshenko E.S. i dr. Posleoperacionnye nevrologicheskie narusheniya I tipa u pacientov posle koronarnogo shuntirovaniya // Kardiologiya i serdechno-sosudistaya hirurgiya. – 2011. – № 4 (5). – S. 14–17.

12. Kardiovaskulyarnaya profilaktika. Nacional'nye rekomendacii // Kardiovaskulyarnaya terapiya i profilktika. – 2011. – № 10 (6). – S. 1–64.

13. Van den Oord SC, Sijbrands EJ, ten Kate GL et al. Carotid intima-media thickness for cardiovascular risk assessment: Systematic review and meta-analysis.Atherosclerosis. 2013;228:1-11.

14. Roman MJ, Naqvi TZ, Gardin JM et al. American Society of Echocardiography; Society for Vascular Medicine and Biology Cl inical appl ication of noninvasive vascular ultrasound in cardiovascular risk stratification: a report from the American Society of Echocardiography and the Society for Vascular Medicine and Biology. Amercan Society of Echocardiography Report. Vasc. Med. 2006;11:201-11.

15. Stein JH, Korcarz CE, Hurst RT, et al. American Society of Echocardiography Carotid Intima-Media Thickness Task Force. Use of carotid ultrasound to identify subcl inical vascular disease and evaluate cardiovascular disease risk: a consensus statement from the American Society of Echocardiography Carotid Intima-Media Thickness Task Force. Endorsed by the Society for Vascular Medicine. J. Am Soc Echocardiogr 2008;21(2):93111.

16. Sanne AE Peters, Hester M den Ruijter, Michiel L Bots, Karel G M. Moons Improvements in risk stratification for the occurrence of cardiovascular disease by imaging subcl inical atherosclerosis: a systematic review. Heart. 2012;98:177-84.

17. Eugene Lin , Beverly Hashimoto, Wayne Hwang Imaging of Subcl inical Atherosclerosis: Questions and Answers. Current Problems in Diagnostic Radiology. 2011;40930;116-26.

18. David C. Goff Jr, MD, PhD, FACP, FAHA, Co-Chair; Donald M. Lloyd-Jones, MD, ScM, FACC, FAHA, Co-Chair; Glen Bennett, MPH; Sean Coady, MS et al. ACC/AHA Prevention Guidel ine 2013 ACC/AHA Guidel ine on the Assessment of Cardiovascular Risk A Report of the American College of Cardiology/American Heart Association Task Force on Practice Guidelines Circulation. 2014;129:49-73.

19. Jaffer FA, O’Donnell CJ, Larson MG, Chan SK, Kissinger KV, Kupka MJ, Salton C, Botnar RM, Levy D, Manning WJ. Age and sex distribution of subcl inical aortic atherosclerosis: a magnetic resonance imaging examination of the Framingham Heart Study. Arterioscler Tromb-Vasc Biol. 2002;22(5):849-54.

20. Pomogailo BV, Bovtusko PV, Fil ippov AE, Havanshanov AK. Ultrasound markers of subcl inical atherosclerosis of carotid arteries and aorta in men of young and middle age. Fundamental research 2012;8:285-8. Russian (Pomogajlo B.V., Bovtyushko P.V., Fillipov A.E., Havanshanov L.K. Ul'trazvukovye markery subklinicheskogo ateroskleroza monnyh arterij i aorty u muzhchin molodogo i srednego vozrasta. Fundamental'nye issledovaniya 2012;8Zh285-8).

21. Charalambos V, Xaplanteris P, Aboyans V, et al. The role of vascular biomarkers for primary and secondary prevention. A position paper from the European Society of Cardiology Working Group on peri pheral circulation: Endorsed by the Association for Research into Arterial Structure and Physiology (ARTERY) Society. Atherosclerosis. 2015;(2):507-32.

22. Ram Bedi, Aslam Nagra, Takenori Fukumoto et al. Detection of Subcl inical Atherosclerosis in Peri pheral Arterial Beds With B-Mode Ultrasound: A Proposal for Guiding the Decision for Medical Intervention and an Artifact-Corrected Volumetric Scoring Index. Global Heart 2014;9(4):367-78.

23. Pomogajlo B.V., Bovtyushko P.V., Fillipov A.E., Havanshanov L.K. Ul'trazvukovye markery subklinicheskogo ateroskleroza monnyh arterij i aorty u muzhchin molodogo i srednego vozrasta. Fundamental'nye issledovaniya 2012;8Zh285-8

24. Huibers GJ, de Borst S,Wan F, Kennedy A,Giannopoulos FL, Moll T. Richards. Non-invasive Carotid Artery Imaging to Identify the Vulnerable Plaque: Current Status and Future Goals Eur J Vasc Endovasc Surg. 2015;1-10.

25. Nakamura J, Nakamura T, Deyama J et al. Assessment of carotid plaque neovascularization using quantitative analysis of contrast-enhanced ultrasound imaging is useful for risk stratification in patients with coro nary artery disease International Journal of. Cardiology. 2015;195:113-9.

26. Vasileios Rafailidis Georgios Pitoulias, Konstantinos Kouskouras, Dimitrios Rafailidis. Contrast-enhanced ultrasonography of the carotids Ultrasonography. 2015.

27. Vancraeynest D, Pasquet A, Roelants V, Gerber BL. Imaging the Vulnerable Plaque J. Am Col of Cardiol. 2011;57(20):1961-79.

28. Staub D, Schinkel AF, Coll B et al. Contrast-Enhanced Ultrasound Imaging of the Vasa Vasorum: From Early Atherosclerosis to the Identification of Unstable Plaques JACC Cardiovasc Imaging. 2010;3(7):761-71.

29. Kawasaki M. An integrated backscatter ultrasound technique for the detection of coronary and carotid atherosclerotic lesions. Sensors (Basel) 2015;15(1):979-94.

30. Katakami N, Kaneto H, Matsuhisa M et al. Clustering of several cardiovascular risk factors affects tissue characteristics of the carotid artery. Atherosclerosis 2008;198:208-13.

31. Yamada K, Yoshimura S, Enomoto Y et al. Evaluation of symptomatic carotid plaques by tissue characterization using integrated backscatter ultrasound and magnetic resonance imaging. Cerebrovasc. Dis. 2011;31(3):305-12.

32. Burmistenko O.S., Semenova A.E., Nozadze D.N. Instrumental'nye i laboratornye metody v vyyavlenii nesiabil'nyh ateroskleroticheskih blyashek // Ateroskleroz i dislipidemii. – 2013. – № 12 (3). – S. 4–10.

33. Hitchner E, Zayed MA, Lee G, Morrison D, Lane B, Zhou W. Intravascular ultrasound as a clinical adjunct for carotid plaque characterization. J Vasc Surg. 2014;59(3):774-80.

34. Balahonova T.V., Zhernakova Yu.V., Kaveshnikov V.S. i dr. Rasprostranennost' karotidnogo ateroskleroza v neorganizovannoj populyacii Tomska // Sistemnye gipertenzii. – 2014. – № 4 (11). – S. 37–42.

35. Saltykova M.M., Urazalina S.Zh., Balahonova T.V. i dr. Chastota vyyavleniya ateroskleroticheskih blyashek v sonnyh arteriyah u muzhchin i zhenshchin s nizkim i umerennym riskom po shkale SCORE v razlichnyh vozrastnyh gruppah // Kardiologicheskij vestnik. – 2011. – № 2. – S. 16–20.

36. Fernández-Friera, Peсalvo JL, Fernández-Ortiz et al. Vascular Distribution, and Multiterritorial Extent of Subcl inical Atherosclerosis in a Middle-Aged Cohort: The PESA (Progression of Early Subclinical Atherosclerosis) Study Circulation. 2015;131(24):2104-13.

37. Ershova A.I., Meshkov A.N., Deev A.D. i dr. Ateroskleroticheskaya blyashka v sonnyh arteriyah kak marker ris-ka razvitiya serdechno-sosudistyh sobytij v populyacii srednego vozrasta // Kardiovaskulyarnaya terapiya i profilaktika. – 2018. – № 17 (4). – S. 34–39.

38. Hahn C, Schwartz MA. Mechanotransduction in vascular physiology and atherogenesis. Nat. Rev. Mol. Cell Biol. 2009;10: 53-62.

39. Hackett D, Davies G, Maseri A. Pre-existing coronary stenoses in patients with first myocardial infarction are not necessarily severe. Eur Heart. 1988;9(12):1317-23.

40. Hellings WE, Peeters W, Moll FL, Pasterkamp G. From vulnerable plaque to vulnerable patient: the search for biomarkers of plaque destabilization. Trends Cardiovasc Med. 2007;17(5):162-71.

41. Crouse JR, 3rd, Bots ML, Evans GW et al. Does baseline carotid intimamedia thickness modify the effect of rosuvastatin when compared with placebo on carotid intima-media thickness progression? The METEOR study. Eur J. Cardiovasc Prev Rehabil. 2010;17(2):223-9.

42. Shah F, Balan P, Weinberg M et al. Contrast-enhanced ultrasound imaging of atherosclerotic carotid plaque neovascularization: a new surrogate marker of atherosclerosis? Vasc Med. 2007;12(4):291-7.

43. Tsutsui JM , Xie F, Cano M et al. Detection of retained microbubbles in carotid arteries with real-time low mechanical index imaging in the setting of endothelial dysfunction. J Am. Coll Cardiol. 2004;44(5):1036-46.

44. Nakamura J, Nakamura T, Deyama J et al. Assessment of carotid plaque neovascularization using quantitative analysis of contrast-enhanced ultrasound imaging is useful for risk stratification in patients with coronary artery disease International Journal of. Cardiology. 2015;195:113-9.

45. Staub D, Schinkel AF, Coll B et al. Contrast-Enhanced Ultrasound Imaging of the Vasa Vasorum: From Early Atherosclerosis to the Identification of Unstable Plaques JACC Cardiovasc Imaging. 2010;3(7):761-71.

46. Honda O, Sugiyama S, Kugiyama K et al. Echolucent carotid plaques predict future coronary events in patients with coronary artery disease. J Am Coll Cardiol. 2004;43(7):1177-84.

47. Cascyn-Pérez JD, de la Torre-Hernández JM, Ruiz-Abellyn MC et al. Characteristics of culprit atheromatous plaques obtained in vivo by intravascular ultrasound radiofrequency analysis: Results from the CULPLAC study. Am Heart J. 2013;165(3):400-7.