Ultrasonic vascular visual-exercise early diagnosis of arterial hypertension
- Authors: Avkhimenko V.А.1, Trivozhenko А.B.1
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Affiliations:
- Siberian Federal Scientific and Clinical Center of Federal Medical and Biological Agency
- Issue: Vol 35, No 3 (2024)
- Pages: 20-24
- Section: For Diagnosis
- URL: https://journals.eco-vector.com/0236-3054/article/view/629974
- DOI: https://doi.org/10.29296/25877305-2024-03-04
- ID: 629974
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Abstract
High level of prevalence of the arterial hypertension (AH) demands use of new technologies of early disease verification.
Purpose. Develop a visual-exercise method of diagnostics of AH: bicycle-stressful doppler sonography of a renal-vascular blood-groove with assessment of the vascular motion status and definition of diagnostic criteria of disease.
Materials and methods. The cohort (n=48) of healthy subjects and patients with AH I-II degree is surveyed. Bicycle-stressful research of renal-vascular reactivity included initial measurement and exercise monitoring of peak speed of a blood-groove (Vps) and the resistant index (RI) in renal artery (RA). Calculation the index of the pressor and high-speed relation (IPHSR) on a formula was carried out: IPHSR = Systolic BP/ Vps RA.
Results. At peak bicycle-stressful test the VpsRA at patients with AH increased only 8% (2.8–11.0%) while at healthy volunteers – 27% (21.4–37.0%). Significantly differed IPHSR: at patients with AH it was measured 2.38–3.23 units (2.8 [2.650–2.892] units), and healthy volunteers 1.72–2.37 units (2.03 [1.91–2.16] units) (p=0,0001). The sensitivity of IPHSR was 91%, specificity – 88%, accuracy – 93%. The decrease of cortically kidney perfusion (increase in RI RA) in group of control was less expressed, than group of patients with AH: 8,6% (4.3–11.0) and 14.7% (9.7–23.2] respectively (r=0,0004).
Conclusion. In the course of bicycle-exercise at patients with AH load the small growth of peak speed (<10%) and the essential growth of vascular resistance (>25%), the IPHSR is highly sensitive (91%) and highly specific (88%) criterion of AH with differential border of 2,5 units.
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About the authors
V. А. Avkhimenko
Siberian Federal Scientific and Clinical Center of Federal Medical and Biological Agency
Author for correspondence.
Email: borisah@yandex.ru
ORCID iD: 0000-0002-2178-601X
Candidate of Medical Sciences
Russian Federation, SeverskА. B. Trivozhenko
Siberian Federal Scientific and Clinical Center of Federal Medical and Biological Agency
Email: borisah@yandex.ru
ORCID iD: 0000-0001-6449-9523
MD
Russian Federation, SeverskReferences
- Баланова Ю.А., Шальнова С.А., Имаева А.Э. и др. от имени участников исследования ЭССЕ-РФ-2. Распространенность артериальной гипертонии, охват лечением и его эффективность в Российской Федерации (данные наблюдательного исследования ЭССЕ-РФ-2). Рациональная Фармакотерапия в Кардиологии. 2019; 15 (4): 450–66 [Balanova Y.A., Shalnova S.A., Imaeva A.E. et al. on behalf of ESSE-RF-2 researchers. Prevalence, Awareness, Treatment and Control of Hypertension in Russian Federation (Data of Observational ESSE-RF-2 Study). Rational Pharmacotherapy in Cardiology. 2019; 15 (4): 450–66 (in Russ.)]. doi: 10.20996/1819-6446-2019-15-4-450-466
- Чазова И.Е., Жернакова Ю.В. от имени экспертов. Клинические рекомендации. Диагностика и лечение артериальной гипертонии. Системные гипертензии. 2019; 16 (1): 6–31 [Chazova I.E., Zhernakova Yu.V. on behalf of the experts. Clinical guidelines. Diagnosis and treatment of arterial hypertension. Systemic Hypertension. 2019; 16 (1): 6–31 (in Russ.)]. doi: 10.26442/2075082X.2019.1.19017
- Смирнова М.И., Горбунов В.М., Кошеляевская Я.Н. и др. Характеристики больных с воспроизводимой скрытой артериальной гипертонией и подход к ее диагностике. Рациональная Фармакотерапия в Кардиологии. 2019; 15 (6): 789–94 [Smirnova M.I., Gorbunov V.M., Koshelyaevskaya Y.N. et al. Characteristics of Patients with Reproducible Masked Hypertension and its Diagnosis Approach. Rational Pharmacotherapy in Cardiology. 2019; 15 (6): 789–94 (in Russ)]. doi: 10.20996/1819-6446-2019-15-6-789-794
- Заяц А.Н. Шишко В.И. Характеристика типов гемодинамического ответа при выполнении велоэргометрии у мужчин в возрасте18-29 лет с синдромом артериальной гипертензии. Лечебное дело. 2021; 1 (76): 43–9 [Zaiac A.N. Shishko V.I. hare. The characteristic of types of the haemo dynamic answer when performing a veloergometriya at men in vozraste18-29 years with a syndrome of arterial hypertension. Lechebnoe delo. 2021; 1 (76): 43–9 (in Russ.)].
- Хурса Р.В. Квази-гипертензия при суточном мониторировании артериального давления. Здравоохранение. 2015; 7:27–35 [Hursa R.V. Kvazi-gipertenziya at daily monitoring of arterial blood pressure. Health care. 2015; 7: 27–35 (in Russ.)].
- Тихоненко В.М., Пивоваров В.В., Рубинский А.В. и др. Перспективы велоэргометрии с измерением артериального давления на каждом сердечном сокращении. Медицинский алфавит. 2022; 33: 8–12 [Tihonenko V.M., Pivovarov V.V., Rubinskiy A.V. et al. Outlook for ergometer testing with beat to beat blood pressure measurement. Medical alphabet. 2022; 33: 8–12 (in Russ.)]. doi: 10.33667/2078-5631-2022-33-8-12
- Voitikova M.V., Khursa R.V. Classification of hemodynamics using a diagnostic nomogram and ambulatory blood pressure data. Nonlinear Phenomena in Complex Systems. 2020; 23 (3): 291–8. doi: 10.33581/1561-4085-2020-23-3-291-298
- Мельникова Л.В., Осипова Е.В. Поражение почек при эссенциальной артериальной гипертензии: патогенетические основы ранней диагностики. Артериальная гипертензия. 2019; 25 (1): 6–13 [Melnikova L.V., Osipova E.V. Kidney damage in essential arterial hypertension: pathogenetic issues for early diagnostics. Arterial Hypertension. 2019; 25 (1): 6–13 (in Russ.)]. doi: 10.18705/1607-419X-2019-25-1-6-13
- Кобалава Ж.Д., Троицкая Е.А., Колесник Э.Л. Современные рекомендации по артериальной гипертонии: согласованные и несогласованные позиции. Рациональная Фармакотерапия в Кардиологии. 2019; 15 (1): 105–14 [Kobalava Z.D., Troitskaya E.A., Kolesnik E.L. New guidelines on management of arterial hypertension: key similarities and differences. Rational Pharmacotherapy in Cardiology. 2019; 15 (1): 105–14 (in Russ.)]. doi: 10.20996/1819-6446-2019-15-1-105-114
- Беленков Ю.Н., Привалова Е.В., Данилогорская Ю.А. и др. Ремоделирование сосудистого русла у больных артериальной гипертонией: возможности диагностики и коррекции. Кардиология. 2012; 52 (6): 67–72 [Belenkov Yu.N., Privalova E.V., Danilogorskaya Yu.A. et al. Remodeling of vascular bed in patients with arterial hypertension: possibilities of diagnostics and correction. Cardiology. 2012; 52 (6): 67–72 (in Russ.)].
- Manohar M., Goetz T.E., Saupe B. et al. Thyroid, renal, and splanchnic circulation in horses at rest and during short-term exercise. Am J Vet Res. 1995; 56 (10): 1356–61.
- Rocha M.P., Mentetzides S.H., Drew R.C. Renal blood flow during exercise: understanding its measurement with Doppler ultrasound. J Appl Physiol. 2023; 134 (4): 1004–10. doi: 10.1152/japplphysiol.00392.2022
- Drew R.C., Muller M.D., Blaha C.A., et al. Renal vasoconstriction is augmented during exercise in patients with peripheral arterial disease. Physiol Rep. 2013; 1 (6): e00154. doi: 10.1002/phy2.154
- Kawakami S., Yasuno T., Kawakami S. et al. The moderate-intensitycontinuous exercise maintains renal blood flow and does not impair the renal function. Physiol Rep. 2022; 10 (15): e15420. DOI: 10.14814/ phy2.15420
- Rocha M.P. Gliemann L. Exercise and the kidneys: How does renal blood flow behave when measured during exercise? Physiol Rep. 2022; 10 (19): e15485. doi: 10.14814/phy2.15485
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