Aortic pulse wave velocity as additional prognostic criteria in abdominal obesity
Aim. To evaluate the opportunities for application of pulse wave velocity measurements (PWV) in aorta as prediction instrument as additional method in cardiovascular risk (CVR) stratification in patients with abdominal obesity (AO). Material and methods. Totally 132 normotensive patients studied with AO and SCORE risk <5%, at the age 31-55 (mean age 45,0±5,3); we measured lipid profile, glycemic profile, glomerular filtration rate, microalbuminuria (MAU), performed triplex scanning of carotid arteries (CA) echocardioscopy, bifunctional 24-hour blood pressure monitoring with assessment of mean daily PWV in aorta. As additional prediction instrument in CVR stratification we meant PWV >75 percentile for the respective age range - 8,0 m/s for persons of 31-45 years old and 8,3 m/s for 46-55 years old. Results. In patients with PWV in aorta >75th percentile organ damage was found more often - carotid atherosclerosis - 44,1% vs 5,1% (p<0,01); CA wall hypertrophy - 50,0% vs 26,5% (p<0,05); MAU - 32,4% vs 0% (p<0,01). The criteria chosen for vessel wall rigidity made it to reveal 100% of persons with MAU, 42,9% with left ventricle hypertrophy, 39,5% with CA wall hypertrophy, 75,0% with carotid atherosclerosis among all patients with AO, that was comparable with the analogic parameters in case of traditional method application with the same aim in model of metabolic syndrome. At the same time the prevalence of carotid atherosclerosis and MAU in the first subgroup was significantly higher - 44,1% vs 16,2% and 32,4% vs 10,8%, resp. (p<0,01). Conclusion. For the patients with AO and low and moderate CVR by SCORE in case of PWV in aorta at the range >75 percentile for the respective age diapason it is aimfull to do screening of subclinical atherosclerosis for consequent reclassification of CVR and reconsideration of the necessary prevention events.