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Abstract
Cerebrovascular diseases are one of the most important causes of morbidity and mortality in the adult population. Objective: to conduct a comparative analysis of morphological and functional changes in the heart, intracardiac and systemic hemodynamics in elderly patients with cerebral atherosclerosis (CA) of grade 1-3 and type 2 diabetes mellitus (T2D), depending on the hemispheric localization of the ischemic focus, and to determine age and sex differences
in these ones. Material and methods: 229 patients with CA of grade 1-3 and T2D took part in a complex study. The patients were divided into 4 groups: 1st group — those who had an ischemic stroke (IS) in the right hemisphere (RH), 2nd group — those who had IS in the left hemisphere LH), 3rd group — with grade 1-2 CA (without IS — a comparison group) and 4th group — the general group of patients after ischemic atherothrombotic stroke (IS). The design
was a simple, prospective, non-randomized study with consecutive enrollment of patients. Results and discussion: The compared groups statistically significantly differed in the LH index, end-diastolic size index, end-systolic size index and left ventricular (LV) wall thickness. Hemispheric differences were registered only in relation to the stroke index (SI) value. Eccentric dilated LVH was most often observed in patients with IS — 2.2 times more often than in patients with CA, and concentric dilated LVH was more common in patients with CA — 1.8 times more often than in patients with IS. Interhemispheric
differences were observed only in relation to types III and V of LVH. For patients with grade 1-2 CA and T2D, age and sex differences in the structural and functional state of the heart have not been established. For patients undergoing IS with T2D, the following age and sex differences are characteristic: for example, large sizes of the LV cavity, SV, MCV are statistically significantly inherent in men, and statistically significantly smaller sizes of the LV cavity and
greater LV wall thickness are observed after 60 years. Conclusions: in patients with CA of grades 1-3, statistically significant differences are observed in morpho-functional changes in the heart, intracardiac and systemic hemodynamics and LV geometry, and some of these differences are of a «hemispheric» nature, and age and sex differences are characteristic only for patients with IS and T2D.
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