Ultrasonic vascular visual-exercise early diagnosis of arterial hypertension

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 (25%), the IPHSR is highly sensitive (91%) and highly specific (88%) criterion of AH with differential border of 2,5 units.