[Structural and functional status of arteries in young and middle-aged men with ischemic heart disease]

Area of Science:

• Cardiovascular Medicine
• Vascular Biology
• Diagnostic Imaging

Background:

• Ischemic heart disease (IHD) affects individuals across different age groups, but the specific vascular changes in younger versus middle-aged men are not fully elucidated.
• Understanding arterial status differences is crucial for early detection and risk stratification in IHD patients.
• Current research often focuses on older populations, leaving a gap in knowledge regarding younger IHD cohorts.

Purpose of the Study:

• To investigate differences in the structural and functional status of arteries between young and middle-aged men diagnosed with ischemic heart disease (IHD).
• To compare vascular parameters in men with obstructive coronary atherosclerosis against a control group without clinical IHD manifestations.
• To identify specific arterial markers associated with IHD in a younger male population.

Main Methods:

• Recruitment of 78 men (aged 28-50 years), including 49 with obstructive coronary atherosclerosis and 29 controls.
• Exclusion criteria included arterial hypertension, diabetes mellitus, and marked hypercholesterolemia (LDL ≥ 4.5 mmol/l).
• Carotid ultrasound, endothelial function tests (brachial artery flow-mediated dilation), and arterial stiffness measurements (aortic pulse wave velocity) were performed.

Main Results:

• Men with IHD exhibited a higher prevalence of multiple carotid plaques (86.7% vs. 13.7%, p<0.001) compared to controls.
• Increased aortic pulse wave velocity (PWV), a measure of arterial stiffness, was significantly more common in the IHD group (53.1% vs. 24.1%, p=0.02).
• Aortic PWV correlated with the severity of coronary atherosclerosis; however, carotid intima-media thickness and brachial artery flow-mediated dilation did not significantly differ between groups.

Conclusions:

• Younger and middle-aged men with IHD demonstrate significant differences in arterial structure and stiffness, characterized by increased carotid plaques and aortic PWV.
• Aortic pulse wave velocity emerges as a sensitive indicator of coronary atherosclerosis severity in this cohort.
• While endothelial function (FMD) and intima-media thickness were not significantly different, PWV highlights impaired arterial stiffness as a key feature in IHD men.