The detection rate of non-invasive markers of subclinical atherosclerosis of brachyocephalic and coronary arteries with an assessment of their relationship in patients with arterial hypertension
Authors: Lobanova N Y , Chicherina E N 
Published: October 2021

Abstract

Introduction
Atherosclerosis is a chronic, progressive, inflammatory disease, which is characterized by an undulating course and multifocal nature of the lesion. Arterial hypertension (AH) is widespread in the population, and also contributes to the development and progression of atherosclerosis. Non-invasive imaging techniques make it possible to diagnose atherosclerosis, also at its subclinical stage. The detection of coronary calcification, atheromatous plaques in the brachiocephalic arteries (BCA), and the detection of the ankle-brachial index (ABI) are referred to as non-invasive markers of atherosclerosis. Estimation of the strength of the relationship between the detection rate of non-invasive markers of atherosclerosis in AH is on the front burner.

Purpose
To estimate the presence and degree of relationship between non-invasive markers of subclinical atherosclerosis in patients with AH.

Methods
99 patients were studied with an proven diagnosis of AH, without anamnesis of symptomatic diseases of atherosclerotic genesis. Median age is 58 years, of them 37 are men. To detect subclinical atherosclerotic lesions of the coronary arteries (CA), all persons included in the study, after obtaining informed consent, were performed the multispiral computed tomography of CA on a 64-slice computed tomography Optima CT 660 (General Electric Co, USA) with the calculation of the cardiac calcium score (CCS) according to the Agatston score. Duplex ultrasound of BCA and determination of ABI value was performed using a supersonic diagnostic apparatus Vivid E9 (General Electric Co, USA) according to the standard procedure. Statistical data processing was performed using the Statistica for Windows ver 10.0 software (StatSoft, Inc., USA). To describe the relationship between the parameters under study, the Kendall's rank correlation coefficient was used (at a statistical significance p&lt;0.05).

Results
Subclinical atherosclerotic lesions of CA (CCS &gt;0) was detected in 53 persons (53.5%), and BCA (presence of atheromatous plaque) – in 52 persons (52.5%). In 13 patients (13.1%), a decrease in ABI &lt;0.9 was recorded. Correlation analysis revealed the presence of a direct correlation of average strength between subclinical lesions of the BCA (presence of atheromatous plaque) and CA (CCS &gt;0), τb=0.33 (95% CI: 0.14; 0.49), p&lt;0.001). Besides, atherosclerotic lesions of BCA had a negative correlation weak strength with subclinical peripheral arterial lesion (ABI &lt;0.9) τb=−0.19 (95% CI: −0.37; 0.01), p=0.005. We have not detected a correlation between the ABI decrease and the presence of coronary calcification.

Conclusion
Subclinical lesions of CA and BCA were more often detected in persons with AH (in 53.5% and 52.5%, respectively). Correlation analysis showed that in persons with AH, subclinical BCA lesion is positively associated with the presence of coronary calcification and has a weak negative relationship with a decrease value of ABI.

Funding Acknowledgement
Type of funding sources: None.