Vnitr Lek 2003, 49(3):185-188

[Importance of measurement of carotid artery distensibility].

J Chlumský, J Charvát: Interní klinika 2. lékarské fakulty UK a FN Motol, Praha.

Affections of the structure of the major blood vessels can be assessed non-invasively by ultrasound. The authors assessed the thickness of the intima-media (IMT) and distensibility (D) of the carotid arteries in patients with ischaemic heart disease (IHD) and a cerebrovascular attack (CVA). Duplex sonography was used in 234 patients (145 patients with IHD and 89 patients with CVA) incl. assessment of IMT and D. 59 patients had type 2 diabetes and 64 had atrial fibrillations. D was evaluated according to Raneman's formula (mm/100 mm Hg). Diabetic subjects had a poorer D in the group with IHD (0.16 vs. 0.20, p < 0.05) as well as in the CVA group (0.14 vs. 0.17, p < 0.05) and the finding correlated with IMT. Insulin treatment as compared with PAD treatment did not influence D in a significant way (0.15 vs. 0.16, NS). Th presence of atrial fibrillation in patients with IHD did not affect the investigated parameters (IMT 0.72 vs. 0.74 mm, NS, D 0.19 vs. 0.18, NS). In patients with CVA, as compared with patients with a sinus rhythm, better IMT findings were recorded (0.67 mm vs. 0.79 mm, p < 0.05) and D (0.19 vs. 0.10, p < 0.05). The results indicate that IMT an D correlate indirectly and this is made more apparent by the presence of diabetes. In patients with CVA the different findings in relation to the presence of atrial fibrillation indicate the possibility to use these parameters to differentiate an embolic and thrombotic etiology of the attack. The results assembled by the authors do not support a better informative value of D as compared with IMT.