Arterial stiffness in patients with asthma T.A.Brodskaya Научный руководитель: V.A.Nevzorova, B.I.Geltser Vladivostok State Medical University, Vladivostok, Russia Methods Abstract Objectives Results Conclusions References 1. Schanen J.G., Iribarren C., Shahar E. et al. Asthma and incident cardiovascular disease: the Atherosclerosis Risk in Communities Study. Thorax, 2005; 60(8): Zieman S.J., Melenovsky V., Kass D.A. Mechanisms, Pathophysiology, and Therapy of Arterial Stiffness. Arterioscler. Thromb. Vasc. Biol. 2005; 5(25): Laurent S., Cockcroft J., Van Bortel L. et al. the European Network for Non-invasive Expert consensus document on arterial stiffness: methodological issues and clinical applications Eur. Heart J. 2006; 27(21): Brodskaya T.A., Geltser B.I., Nevzorova V.A., Motkina E.V. Clinical-functional estimation of arterial stiffness at the bronchial asthma. Clinical medicine. 2007; 6 : Arteriograph TensioClinic and its program TensioClinic. User’s manual. Early diagnosis of arteriosclerosis. A vascular disturbances has a great importance in asthma pathogenesis [1]. The exacerbation of asthma is accompanied by increase in risk of cardiovascular complications. Research of mechanical properties of vessels, in particular of arterial stiffness has special interest for the estimation of cardiovascular system function [2,3]. Augmented arterial stiffness essentially influences on hemodynamics, by increasing of myocardium postloading and worsening of coronary perfusion conditions. In traditional clinical practice an increase arterial stiffness associates first of all with atherosclerosis and ageing. However the great value in infringement of vessels mechanical properties givens to functional (transitory) factors. It is possible to attribute to its an increase in a shift pressure, increase of concentration of circulating vasoactive hormones, inflammation mediators, oxidative stress products, etc. Special value in a number of such factors belongs to functional activity of the vascular endothelium and the smooth muscle cells [2,4]. At the same time, there is having only individual data on aortic mechanical properties in asthma patients [4]. The purpose of this research was to estimate an arterial stiffness in asthma patients. With the purpose of research the mechanical properties of central vessels we examined 54 patients with severe and moderate asthma by noninvasive arteriography (arteriograph TensioClinic TL1 (TensioMed, Hungary)). Control group included 25 age- and sex-matched healthy volunteers. Results: The aortal stiffness in asthma exacerbation was significant more, than in healthy persons. It was expressed in increase of aortic pulse wave velocity (aPWV) and augmentation index (IA). APWV in patients with severe asthma a two fold surpassed aPWV in healthy persons. IA in such patients a 6 fold surpassed control level. Significant raised arterial stiffness can take part in increasing cardiovascular risk during asthma exacerbation. Independently of increasing arterial stiffness in asthma exacerbation, aPWV and IA essentially improved and came nearer to control level in asthma remission. That suggests functional character of these changes. Augmented arterial stiffness in asthma correlates to lung ventilation dysfunction and hypoxia, disease duration and severity. Conclusion: Described changes can explain cardiovascular events rising in patients with exacerbation of asthma. Our data suggests transitory character of arterial stiffness increasing in asthma exacerbation. The aortal stiffness in asthma exacerbation was significant more, than in healthy persons. It was expressed in increase of aortic pulse wave velocity (aPWV) and augmentation index (AIx). APWV in patients with severe asthma a two fold surpassed aPWV in healthy persons and was 10,5  1,3m/s. AIx in such patients a 6 fold surpassed control level and was 14,4  5,8%. Significant raised (р<0,001) arterial stiffness can take part in increasing cardiovascular risk during asthma exacerbation. Independently of increasing arterial stiffness in asthma exacerbation, aPWV and AIx essentially improved and came nearer to control level in asthma remission. That suggests functional character of these changes. Augmented arterial stiffness in asthma correlates to lung ventilation dysfunction and hypoxia, disease duration and severity (table). We described the increasing of arterial stiffness in asthma exacerbation. This changes can explain cardiovascular events rising in such patients. Our data suggests transitory character of arterial stiffness increasing in asthma exacerbation We examined 54 patients with severe and moderate asthma by noninvasive arteriography (arteriograph TensioClinic TL1 (TensioMed, Hungary)) [5]. Control group included 25 age- and sex-matched healthy volunteers. Figure 2. The typical aortic pulse waves forms according to indirect arteriography. On axis X - time, a step = 200мsec; on axis Y - pulse wave amplitude, a step = 40 mm hg. Р1 - direct pulse wave peak, Р2 - return pulse wave peak. - indicator of return pulse wave returning ; - duration of left ventricular ejection period A)healthy person B)moderate asthma exacerbation C)severe asthma exacerbation Figure 1. Schematic bases of indirect arteriography A B C