World-Class Research Center, Digital Biodesign and Personalized Healthcare, I.M. Sechenov First Moscow State Medical University (Sechenov University), 119991, Moscow, Russia.
Cardiovasc Hematol Agents Med Chem. 2024;22(2):181-186. doi: 10.2174/0118715257246589231018053646.
Cardiovascular disease and diabetes mellitus are among the leading causes of mortality.
Our study evaluated endothelial function in patients with arterial hypertension, coronary heart disease, and diabetes mellitus.
This study aimed to assess the degree of endothelial dysfunction in individuals with cardiovascular risk factors older than 55 years of age.
A total of 112 patients were subdivided into three groups according to the existing disease; the first group consisted of 50 patients diagnosed with arterial hypertension (AH), the second group consisted of 30 patients with ischemic heart disease (IHD), and the third group included 20 patients with type 2 diabetes mellitus (DM). The control group included 12 practically healthy volunteers, comparable in age and sex. Exclusion criteria were age under 55 years, severe concomitant diseases in the acute phase or acute infectious diseases, and oncopathology. Considered factors of cardiovascular risk include dyslipidemia, elevated fasting blood glucose, hypertension, obesity, cigarette smoking, and heredity for CVD. Moreover, tests were conducted with the help of the device 'AngioScan-01' (LLC "AngioScan Electronics"). Endothelium-dependent vasodilation (EDV), the index of stiffness of the vascular wall (SI), and the atherogenic index (log ( )) were evaluated. The analysis of the data obtained was carried out using the IBM SPSS Statistic program.
In the control group, the atherogenic index was in the range of 3.34 (the normal is up to 3.5). The highest atherogenic index, 4.01, was observed in the DM group (differences with the control group are statistically significant). In the AH and IHD groups, the atherogenic index was 3.57 and 3.65, respectively. In the control group, the level of glycemia was 4.45 mmol/l. The highest level of fasting glucose was reported in the DM group, , 6.7 mmol/l (differences with the control group were statistically significant). In the first and second groups, the fasting glucose level was 5.07 mmol/l and 5.08 mmol/l, respectively. In the control group, the mean EDV score was 2,056 ± 0.757 mm, and the lowest EDV in the DM group was 1.365 ± 0.413, but in the AH and IHD groups, it was also significantly reduced by 1.404 ± 0.440 and 1.377 ± 0.390, respectively. The stiffness index in the control group was 6.725 ± 0.776 m/s. In the DM group, this parameter was 8.258 ± 0.656 m/s; in the AH and IHD groups, it was 7.398 ± 1.330 m/s and 7.486 ± 0.816 m/s, respectively.
In conclusion, the study of endothelial function using non-invasive angioscan reflects the influence of risk factors on the vascular wall. The most severe endothelial dysfunction is expressed in patients with diabetes. The results of endothelium-dependent vasodilation and the vascular wall stiffness index (SI) correspond to the scale of evaluation of the 10-year CVD mortality risk (SCORE). These results indicate a deterioration in the vascular ability to vasodilate in patients in response to mechanical deformation of the endothelium and the effect of NO on smooth muscle vascular cells.
心血管疾病和糖尿病是主要的死亡原因之一。
我们的研究评估了动脉高血压、冠心病和糖尿病患者的内皮功能。
本研究旨在评估年龄大于 55 岁的心血管危险因素患者的内皮功能障碍程度。
根据现有疾病将 112 名患者分为三组；第一组 50 名患者诊断为动脉高血压（AH），第二组 30 名患者患有缺血性心脏病（IHD），第三组包括 20 名 2 型糖尿病（DM）患者。对照组包括 12 名实际健康志愿者，年龄和性别相当。排除标准为年龄小于 55 岁、急性阶段的严重合并症或急性传染病以及肿瘤病理学。考虑的心血管危险因素包括血脂异常、空腹血糖升高、高血压、肥胖、吸烟和 CVD 遗传。此外，使用设备'AngioScan-01'（LLC“AngioScan Electronics”）进行测试。评估了内皮依赖性血管舒张（EDV）、血管壁僵硬指数（SI）和动脉粥样硬化指数（log（））。使用 IBM SPSS Statistic 程序对获得的数据进行分析。
在对照组中，动脉粥样硬化指数在 3.34 范围内（正常范围为 3.5 以下）。在 DM 组中观察到最高的动脉粥样硬化指数 4.01（与对照组差异具有统计学意义）。在 AH 和 IHD 组中，动脉粥样硬化指数分别为 3.57 和 3.65。在对照组中，血糖水平为 4.45mmol/l。DM 组报告的空腹血糖水平最高，为 6.7mmol/l（与对照组差异具有统计学意义）。在第一和第二组中，空腹血糖水平分别为 5.07mmol/l 和 5.08mmol/l。在对照组中，平均 EDV 评分为 2.056±0.757mm，DM 组的 EDV 最低为 1.365±0.413，但在 AH 和 IHD 组中，EDV 也分别显著降低至 1.404±0.440 和 1.377±0.390。对照组的刚度指数为 6.725±0.776m/s。在 DM 组中，该参数为 8.258±0.656m/s；在 AH 和 IHD 组中，分别为 7.398±1.330m/s 和 7.486±0.816m/s。
总之，使用非侵入性的血管扫描研究内皮功能反映了危险因素对血管壁的影响。在糖尿病患者中，内皮功能障碍最严重。内皮依赖性血管舒张和血管壁僵硬指数（SI）的结果与心血管疾病 10 年死亡率风险（SCORE）的评估量表相对应。这些结果表明，在患者中，血管对机械变形的内皮和一氧化氮对平滑肌血管细胞的影响的舒张能力恶化。
