Structural and functional changes
of extra- and intracranial arteries
in patients with ischemic heart disease of different ethnic groups

Objective. The structural and functional changes in extraand intracranial arteries in patients from different ethnic groups with coronary artery disease (CAD) before coronary arteriography and operative intervention were studied. Design and methods. We examined 120 patients with CAD including 50 patients of Korean nationality aged 54–73 years (average age 62,5 ± 1,03 years) and 70 patients of Slavic ethnicity aged 53–74 years (mean age 63,2 ± 1,1 years), residents of the Sakhalin Region. All patients received standard antihypertensive, lipid-lowering and antiplatelet therapy. Duplex scanning of extracranial arteries was performed using B-mode, power and color Doppler-mode with spectral analysis of the blood flow. In case of severe stenosis of carotid arteries and in patients with a history of transient ischemic attacks transcranial duplex scanning was performed. Results. Hypertension stage III was diagnosed in 89 % patients of South Asian ethnicity and in 81 % Slavs, and type 2 diabetes mellitus — in 29 and 22 %, respectively. There were no significant differences in mean systolic blood pressure and fasting blood glucose level between the groups. Patients of South Asian ethnicity had higher triglyceride levels and lower values of high-density lipoprotein cholesterol. Conclusions. Ethnicity should be considered when multifocal atherosclerosis structural and functional changes in extra-and intracranial arteries are assessed in patients with CAD. Patients of South Asian ethnicity with CAD show reduced thickness of intima-media complex (1,02 ± 0,01 and 1,07 ± 0,02 mm in the right and left CCA, respectively) compared with the Slavs (1,13 ± 0,02 and 1,23 ± 0,01 mm), although they had more pronounced atherogenic lipid changes inherent to metabolic syndrome. Patients of South Asian ethnicity had 2-fold higher risk of stenotic lesions (> 70 %) and 1,7–2,0-fold risk of pathological deformations of the carotid arteries, which could explain higher rate cerebral circulation disorders in this population compared to those in Caucasians (14 vs. 9 %).

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