Is Stiffness Parameter β Useful for the Evaluation of Atherosclerosis?~ Its Clinical Implications, Limitations, and Future Perspectives ~

Cerebrovascular pulsatility following long duration spaceflight is associated with changes in pulse pressure and carotid artery stiffness

Central artery stiffening increases the haemodynamic pulsations transmitted downstream towards target organs, including the brain. While recent evidence suggests that long duration spaceflight is associated with reduced common carotid artery (CCA) distensibility, cerebrovascular pulsatility has not been extensively characterized in astronauts. This study investigated changes in pulsatility from pre-flight to after 6 months in space, using a secondary analysis of data from four separate experiments. Middle cerebral artery blood velocity (MCAv) was measured during supine rest in 27 astronauts (20 men, 7 women). In subsets of this cohort, we measured CCA distensibility and β stiffness (n = 20), and CCA wave intensity (n = 12). The overall increase in MCAv pulsatility index (PImca) from pre-flight to post-flight was not significant (0.73 ± 0.12 vs. 0.77 ± 0.11, P = 0.060, partial η2 = 0.13). However, individual changes in PImca were directly associated with changes in estimated aortic pulse pressure (r = 0.51, P = 0.007) and β stiffness (r = 0.54, P = 0.015), and inversely associated with changes in distensibility (r = -0.62, P = 0.003), in separate bivariate analyses. Wave intensity analysis suggested a reduction in normalized wave reflection (P = 0.07), and that forward compression wave amplitude was directly related to PImca (r = 0.64, P = 0.025). These findings suggest that PImca in the days immediately following spaceflight is a function of lower carotid distensibility, highlighting the interplay between arterial stiffness and cerebrovascular pulsatility.

Shear Wave Elastography for Carotid Artery Stiffness: Ready for Prime Time?

Carotid artery stiffness is associated with aging and atherosclerotic disease, leading to cerebrovascular events. Shear Wave Elastography (SWE) is a novel ultrasound technique offering a direct, quantitative assessment of the arterial wall elasticity. The aim of this study is to validate the technical feasibility of SWE in measuring carotid stiffness (CS). A literature search was performed across the PubMed and Scopus databases, with keywords including "carotid stiffness", "Shear Wave Elastography", "atherosclerosis", and "vascular elasticity". The findings reveal the potential of SWE in quantifying carotid Intima-Media Complex (IMC) stiffness, with implications for the early diagnosis of vascular disease, aiding in clinical decision making and prognostic assessment. Based on the findings of the literature search, a small pilot study was conducted involving 10 participants, using the Philips EPIQ Elite system for the SWE measurements. The technical analysis revealed optimizing the region of interest (ROI) size, probe positioning, and cine-loop analysis as crucial factors for obtaining accurate results. The results of the literature review and small pilot study demonstrate the potential of SWE as a non-invasive method for assessing carotid stiffness. Certain technical adjustments, such as smaller ROIs and careful probe placement, improved the accuracy and repeatability of carotid SWE measurements. Further studies are needed to assess and standardize carotid SWE across larger patient populations.

Phonocardiography based pulse wave velocity system for non-occlusive assessment of arterial stiffness

Arterial stiffness is strongly associated with vascular aging and pathology and can be assessed in many ways. Existing devices for measuring central arterial stiffness, such as carotid-femoral pulse wave velocity (PWV), are limited by high costs and the need for specialized expertise, limiting widespread clinical adoption. This study introduces a semi- and non-occlusive PWV measurement system using phonocardiography (PCG) and plethysmography (PPG) and a single femoral pressure cuff, aiming to address these limitations. We conducted a study comparing a semi-occlusive (carotid-femoral PWV) and a non-occlusive (carotid-toe PWV) PCG-based PWV measurements across a cohort of 63 volunteers, as compared to literature reference PWV values. Results demonstrated strong correlations between our PCG-based PWV measures (PWVcarotid-femoral: 8.42 ± 3.99 m/s vs. PWVcarotid-toe: 10.62 ± 3.86 m/s) with age as a significant predictor (PWVcarotid-femoral: r 2 = 0.45; PWVcarotid-toe: r 2 = 0.28, p < 0.05). Ultrasound measured distensibility assessments confirmed the reliability of our PCG approach in reflecting central arterial stiffness dynamics, particularly at the aortic level. Test-retest reliability analyses yielded high intraclass correlation coefficients (0.75 ≤ ICC ≤ 90), indicating robust repeatability of our method. This study highlights the feasibility and accuracy of our low-cost, semi and non-occlusive PWV measurement systems to enhance accessibility in arterial stiffness assessments, potentially easing cardiovascular risk stratification.

Implications of Long Sleep Duration on Cardiovascular Health: A Systematic Review

Sleep duration is an important determinant of cardiovascular health, yet the adverse effects of long sleep duration remain underexplored. While short sleep has well-documented associations with increased cardiovascular risk, emerging evidence highlights a U-shaped relationship, with excessive sleep also linked to adverse outcomes. This systematic review evaluates the association between prolonged sleep duration and cardiovascular health outcomes, including coronary artery disease (CAD), stroke, myocardial infarction (MI), hypertension, heart failure (HF), and atherosclerosis. A systematic search of PubMed, Embase, and Web of Science identified 38 studies published between 2008 and 2024 that investigated the relationship between sleep duration and cardiovascular health. Prolonged sleep duration was consistently associated with increased risks of CAD, stroke (ischemic and hemorrhagic), hypertension, and MI. Elevated inflammatory markers, such as C-reactive protein (CRP) and interleukin-6 (IL-6), emerged as potential mediators alongside demographic and lifestyle factors, including age, gender, and socioeconomic status. Long sleep duration may serve as a modifiable risk factor for cardiovascular diseases. Incorporating sleep assessments into cardiovascular risk evaluations could inform prevention strategies, and further research is needed to elucidate mechanisms and develop targeted interventions.

Brachial-Ankle Pulse Wave Velocity Reflects Regional Arterial Stiffness and Distensibility in Patients with Abdominal Aortic Aneurysm

Objectives: We investigated the association between brachial-ankle pulse wave velocity (PWV) and arterial stiffness and distensibility in the aneurysmal sac of abdominal aortic aneurysm (AAA). Methods: Data from 49 patients with AAA from June 2020 to November 2022 at Tokyo Medical University Hospital were retrospectively analyzed. Brachial-ankle PWV (cm/s) was obtained via an automated oscillometric method. Regional arterial stiffness and distensibility parameters, such as stiffness parameter (β), pressure-strain elasticity modulus (Ep, kPa), one-point PWV (PWV β, m/s), and arterial compliance (AC, mm2/kPa-1), were assessed using 2-dimensional automated tissue tracking (2DTT) ultrasonography. Patients were divided into two groups: high PWV (≥1800) and low PWV (<1800). Results: Patients with high PWV showed significantly higher β and PWV β (30.6 ± 10.1 vs. 25.2 ± 6.3, p = 0.047; 11.6 ± 2.3 vs. 10.5 ± 1.5, p = 0.048) and significantly lower AC in the aneurysmal sac (10.6 ± 5.3 vs. 14.7 ± 8.1, p = 0.045) than those with low PWV. AC was negatively correlated with PWV (r = -0.361, p = 0.011). Conclusions: Brachial-ankle PWV can reflect arterial stiffness and distensibility, as measured by 2DTT ultrasonography, in the aneurysmal sac of AAA, suggesting its potential as an elasticity index for assessing regional arterial stiffness and distensibility in AAA.

Are aortic biomechanical properties early markers of dilatation in patients with Marfan syndrome? A systematic review and meta-analysis

Although tissue stiffness is known to play an important role in aortic dilatation, the current guidelines for offering preventative surgery in patients with Marfan syndrome rely solely on the aortic diameter. In this systematic review and meta-analysis, we analyze and compare literature on in vivo aortic stiffness measures in Marfan patients. Our aim is to assess the potential of these measurements as early indicators of aortic dilatation. Following the PRISMA guidelines, we collected literature on diameter and three in vivo stiffness measures: Pulse wave velocity (PWV), β -stiffness index (SI) and distensibility, at five different aortic locations in patients with Marfan syndrome. Results were reviewed and compared against each other. For meta-analysis, an augmented dataset was created by combining data from the literature. Regression with respect to age and statistical comparisons were performed. Thirty articles reporting data from 1925 patients with Marfan and 836 patients without Marfan were reviewed. PWV was found to be higher in Marfan, but only in dilated aortas. Distensibility was found to be lower even in non-dilated aortas, and its decrease was associated with higher chances of developing aortic dilatation. β -SI was higher in Marfan patients and was positively correlated with the rate of aortic dilatation, emphasizing its role as a valuable indicator. In our meta-analysis, all stiffness measures showed a significant variation with age. Distensibility and β -stiffness index were different in Marfan patients at all locations, and the difference was more pronounced after accounting for age-related variation. From the literature, β -SI and distensibility emerge as the best predictors of future aortic dilatation. Our meta-analysis quantifies age-related changes in aortic stiffness and highlights the importance of accounting for age in comparing these measurements. Missing diameter values in the literature limited our analysis. Further investigation of criteria combining stiffness and diameter is recommended to better assist clinical decisions for prophylactic surgery.

Load-dependent mechanisms contribute to increased aortic stiffness among women with a history of preeclampsia: relation with cardiovagal baroreflex sensitivity

Preeclampsia, a hypertensive disorder of pregnancy, results in increased lifetime cardiovascular disease (CVD) risk. Total aortic stiffness, a robust risk factor for CVD, is composed of load-dependent (blood pressure load on arterial wall) and structural (intrinsic changes in arterial wall) mechanisms. Total aortic stiffness is also associated with reduced cardiovagal baroreflex sensitivity (BRS). We sought to determine 1) whether elevated total aortic stiffness among women with a history of preeclampsia (hxPE) is attributed to load-dependent or structural stiffness, and 2) whether either mechanism is associated with lower BRS. Total aortic stiffness (carotid-femoral pulse wave velocity) and spontaneous cardiovagal BRS (sequence technique) were measured among women 1-5 yr postpartum (n = 115; age 34 ± 4 yr; hxPE n = 51; controls n = 64). Structural aortic stiffness was calculated from participant-specific exponential models by standardizing aortic stiffness to a "reference" blood pressure. Load-dependent stiffness was calculated as total minus structural stiffness. Total [+0.8 m/s, 95% confidence interval (CI) (-0.99, -0.23), P = 0.002] and load-dependent [+0.4 m/s, 95% CI (-0.56, -0.22), P < 0.001], but not structural [95% CI (-0.52, 0.08), P = 0.16] aortic stiffness were higher among women with a hxPE compared with controls. Women with a hxPE had lower BRS (P = 0.042) that was negatively associated with total [B = -3.24 ms/mmHg, 95% CI (-6.35, -0.13), P = 0.042] and load-dependent [B = -5.91 ms/mmHg, 95% CI (-11.31, -0.51), P = 0.033] aortic stiffness. Load-dependent, not structural, aortic stiffness mechanisms contribute to higher total aortic stiffness among women with a hxPE and are associated with lower cardiovagal BRS. Postpartum monitoring for high BP is critical to reduce increased CVD risk after preeclampsia.NEW & NOTEWORTHY The novel finding is that load-dependent stiffness, not structural stiffness, is the primary mechanism of aortic stiffness, and is associated with reduced baroreflex sensitivity in women with a history of preeclampsia. These findings may help tailor high blood pressure prevention and management strategies in this population to prevent structural aortic stiffening, altered baroreflex control, and increased lifetime cardiovascular disease (CVD) risk.

Hemodynamics with mechanical circulatory support devices using a cardiogenic shock model

Mechanical circulatory support (MCS) devices, including veno-arterial extracorporeal membrane oxygenation (VA-ECMO) and Impella, have been widely used for patients with cardiogenic shock (CS). However, hemodynamics with each device and combination therapy is not thoroughly understood. We aimed to elucidate the hemodynamics with MCS using a pulsatile flow model. Hemodynamics with Impella CP, VA-ECMO, and a combination of Impella CP and VA-ECMO were assessed based on the pressure and flow under support with each device and the pressure-volume loop of the ventricle model. The Impella CP device with CS status resulted in an increase in aortic pressure and a decrease in end-diastolic volume and end-diastolic pressure (EDP). VA-ECMO support resulted in increased afterload, leading to a significant increase in aortic pressure with an increase in end-systolic volume and EDP and decreasing venous reservoir pressure. The combination of Impella CP and VA-ECMO led to left ventricular unloading, regardless of increase in afterload. Hemodynamic support with Impella and VA-ECMO should be a promising combination for patients with severe CS.

Arterial Stiffness and Heart Failure With Preserved Ejection Fraction

Heart failure with preserved ejection fraction (HFpEF) is prevalent and associated with a poor prognosis, imposing a significant burden on society. Arterial stiffness is increasingly recognized as a crucial factor in the pathophysiology of HFpEF, affecting diagnosis, management, and prognosis. As a hallmark of vascular aging, arterial stiffness contributes to increased afterload on the left ventricle (LV), leading to diastolic dysfunction, a key feature of HFpEF. Elevated arterial stiffness is linked with common cardiovascular risk factors in HFpEF, such as hypertension, diabetes and obesity, exacerbating the progression of disease. Studies have demonstrated that patients with HFpEF exhibit significantly higher levels of arterial stiffness compared to those without HFpEF, highlighting the value of arterial stiffness measurements as both diagnostic and prognostic tools. Moreover, interventions aimed at reducing arterial stiffness, whether through pharmacological therapies or lifestyle modifications, have shown potential in improving LV diastolic function and patient outcomes. Despite these advancements, the precise mechanisms by which arterial stiffness contributes to HFpEF are still not fully understood, necessitating the need for further research.

Endothelial Dysfunction in Obesity and Therapeutic Targets

Parallel to the increasing prevalence of obesity in the world, the mortality from cardiovascular disease has also increased. Low-grade chronic inflammation in obesity disrupts vascular homeostasis, and the dysregulation of adipocyte-derived endocrine and paracrine effects contributes to endothelial dysfunction. Besides the adipose tissue inflammation, decreased nitric oxide (NO)-bioavailability, insulin resistance (IR), and oxidized low-density lipoproteins (oxLDLs) are the main factors contributing to endothelial dysfunction in obesity and the development of cardiorenal metabolic syndrome. While normal healthy perivascular adipose tissue (PVAT) ensures the dilation of blood vessels, obesity-associated PVAT leads to a change in the profile of the released adipo-cytokines, resulting in a decreased vasorelaxing effect. Higher stiffness parameter β, increased oxidative stress, upregulation of pro-inflammatory cytokines, and nicotinamide adenine dinucleotide phosphate (NADP) oxidase in PVAT turn the macrophages into pro-atherogenic phenotypes by oxLDL-induced adipocyte-derived exosome-macrophage crosstalk and contribute to the endothelial dysfunction. In clinical practice, carotid ultrasound, higher leptin levels correlate with irisin over-secretion by human visceral and subcutaneous adipose tissues, and remnant cholesterol (RC) levels predict atherosclerotic disease in obesity. As a novel therapeutic strategy for cardiovascular protection, liraglutide improves vascular dysfunction by modulating a cyclic adenosine monophosphate (cAMP)-independent protein kinase A (PKA)-AMP-activated protein kinase (AMPK) pathway in PVAT in obese individuals. Because the renin-angiotensin-aldosterone system (RAAS) activity, hyperinsulinemia, and the resultant IR play key roles in the progression of cardiovascular disease in obesity, RAAS-targeted therapies contribute to improving endothelial dysfunction. By contrast, arginase reciprocally inhibits NO formation and promotes oxidative stress. Thus, targeting arginase activity as a key mediator in endothelial dysfunction has therapeutic potential in obesity-related vascular comorbidities. Obesity-related endothelial dysfunction plays a pivotal role in the progression of type 2 diabetes (T2D). The peroxisome proliferator-activated receptor gamma (PPARγ) agonist, rosiglitazone (thiazolidinedione), is a popular drug for treating diabetes; however, it leads to increased cardiovascular risk. Selective sodium-glucose co-transporter-2 (SGLT-2) inhibitor empagliflozin (EMPA) significantly improves endothelial dysfunction and mortality occurring through redox-dependent mechanisms. Although endothelial dysfunction and oxidative stress are alleviated by either metformin or EMPA, currently used drugs to treat obesity-related diabetes neither possess the same anti-inflammatory potential nor simultaneously target endothelial cell dysfunction and obesity equally. While therapeutic interventions with glucagon-like peptide-1 (GLP-1) receptor agonist liraglutide or bariatric surgery reverse regenerative cell exhaustion, support vascular repair mechanisms, and improve cardiometabolic risk in individuals with T2D and obesity, the GLP-1 analog exendin-4 attenuates endothelial endoplasmic reticulum stress.

Arterial Stiffness as a Surrogate Marker of Cardiovascular Disease and Atherosclerosis in Patients with Vasculitides: A Literature Review

Vasculitis, a group of systemic inflammatory diseases that affect the cardiovascular (CV) system, presents with a variety of clinical manifestations that depend on the size of the affected blood vessels. While some types of vasculitis reveal distinct symptoms, others are characterized by more diffuse and nonspecific presentations that can result in delayed diagnosis and treatment initiation. Interestingly, patients with vasculitides share a significant comorbidity: an elevated CV risk, contributing to increased rates of CV events and mortality. This heightened risk is caused by cumulative inflammatory burden, traditional CV risk factors, medication effects, and reduced physical fitness. Traditional risk assessment tools, commonly used in the general population, frequently underestimate the CV risk in patients with inflammatory rheumatic conditions. Consequently, novel approaches are necessary to stratify the precise CV risk in vasculitis patients. A number of surrogate parameters for CV risk have been investigated, with arterial stiffness emerging as a promising marker. Pulse wave velocity (PWV) is a well-established method for assessing arterial stiffness and predicting CV risk across different populations. Among numerous PWV variants, carotid-femoral PWV (cfPWV) stands out as the most extensively studied and accepted reference standard. It has demonstrated its utility as a surrogate CV parameter both in the general population and in patients with systemic inflammatory rheumatic diseases. In recent years, research has expanded to assess arterial stiffness in systemic rheumatic diseases, such as arthritis, connective tissue diseases, rheumatologic overlap syndromes, and chronic pain disorders, using measurements of PWV and other markers of arterial compliance and elasticity. Despite burgeoning research in rheumatologic diseases, data on CV risk markers in vasculitides remain limited and fragmented. This narrative review aims to provide a comprehensive overview of arterial stiffness as a potential screening marker for CV diseases, atheromatosis, and ultimately CV risk among patients with vasculitides.

Increasing Soluble P-Selectin Levels Predict Higher Peripheral Atherosclerotic Plaque Progression

BACKGROUND AND AIMS

The adhesion molecule P-selectin is expressed by endothelial cells and platelets. It is involved in platelet activation and leukocyte adhesion, both important processes in the pathogenesis of atherosclerosis. Our study was designed to assess the predictive value of soluble P-selectin (sP-selectin) on the progression of peripheral atherosclerosis.

METHODS

This is an observational, single-center, cohort study that included 443 patients with established cardiovascular disease (CVD) or at least one cardiovascular risk factor. Over a period of 4 years, each patient underwent three-dimensional (3D) ultrasound to assess the plaque volume of the carotid and femoral arteries once per year. In addition, plasma sP-selectin levels were measured at each visit. The association between changes in sP-selectin and peripheral atherosclerotic plaque progression was assessed using growth curve models.

RESULTS

338 patients were available for statistical analysis. Each standard deviation increase in sP-selectin was significantly (p < 0.001) associated with a 46.09 mm3 higher plaque volume. In ROC-analysis, changes in sP-selectin over time showed an optimal cut-off value around Δ 0.0 µg/mL sP-selectin and significantly improved the predictive value of the ESC-SCORE (AUC for the combination of both parameters was 0.75 (95% CI 0.68-0.81, p < 0.001). Patients with increasing sP-selectin showed a significantly higher plaque progression compared to patients with decreasing or stable sP-selectin levels (202 mm3 vs. 110 mm3, p < 0.001).

CONCLUSIONS

Increasing sP-selectin levels can predict higher atherosclerotic plaque progression as measured by 3D ultrasound. We suggest serial measurements of sP-selectin as an easily measurable biomarker for peripheral atherosclerotic plaque progression.

Subjects Conceived through Assisted Reproductive Technologies Display Normal Arterial Stiffness

Multiple studies reported signs of vascular dysfunction in subjects conceived through assisted reproductive technologies (ART). The assessment of arterial stiffness in this cohort seems beneficial for risk stratification. Regional arterial stiffness of the abdominal aorta (AAO) and the common carotid arteries (CCA) was evaluated sonographically using two-dimensional speckle tracking in subjects conceived through ART and spontaneously conceived peers. Global arterial stiffness was assessed utilizing an oscillometric blood pressure device. The cohorts of 67 ART subjects and 86 spontaneously conceived peers (11.31 (8.10-18.20) years vs. 11.85 (8.72-18.27) years, p = 0.43) did not differ significantly in parameters of regional and global arterial stiffness. In the sub-analysis of study participants ≥10 years of age, markers of arterial stiffness did not display significant differences between both groups. However, a higher tendency of brachial systolic blood pressure was demonstrated in the ART cohort compared to the control group (120.18 ± 9.57 mmHg vs. 116.55 ± 8.05 mmHg, p = 0.050). The present study displayed no significant differences in arterial stiffness between ART subjects and spontaneously conceived peers. Moreover, this study suggests that arterial stiffness does not elevate more profoundly in ART subjects with increasing age. Further studies are required for a more detailed cardiovascular risk stratification of the ART cohort.

Impact of Highly Saturated versus Unsaturated Fat Intake on Carbohydrate Metabolism and Vascular Reactivity in Rat

Palm olein (PO) and lard are considered harmful to health because of their highly saturated fatty acid content. On the contrary, olive oil (OO) with its high level of polyunsaturated fatty acids is considered healthier. This study aims to evaluate the effects of high consumption of these oils on carbohydrate metabolism and vascular function. Male Wistar rats were fed ad libitum for 12 weeks with different high fat diets (HFD) containing 30% of each oil. Systemic glycemia, insulinemia, and lipidemia were assessed by routine methods or by ELISA. GLUT4 muscular expression and hepatic and muscular Akt phosphorylation were analyzed by western blot. Vascular function was evaluated, ex vivo, on aortic rings and on the variations of isometric tensions. The results show that fasting blood glucose was increased with PO and OO diets and decreased with lard. Compared to control diet, this increase was significant only with PO diet. The area under the curve of IPGTT was increased in all HFD groups. Compared to control diet, this increase was significant only with PO. In contrast, stimulation of the pathway with insulin showed a significant decrease in Akt phosphorylation in all HFD compared to control diet. KCl and phenylephrine induced strong, dose-dependent vasoconstriction of rat aortas in all groups, but KCl EC₅₀ values were increased with lard and OO diets. The inhibitory effect of tempol was absent in PO and lard and attenuated in OO. Vascular insulin sensitivity was decreased in all HFD groups. This decreased sensitivity of insulin was more important with PO and lard when compared to OO diet. In conclusion, the results of this study clearly show that high consumption of palm olein, olive oil, and lard can compromise glucose tolerance and thus insulin sensitivity. Furthermore, palm olein and lard have a more deleterious effect than olive oil on the contractile function of the aorta. Excessive consumption of saturated or unsaturated fatty acids is harmful to health, regardless of their vegetable or animal origin.

From Cultured Vascular Cells to Vessels: The Cellular and Molecular Basis of Vascular Dysfunction in Space

Life evolved on this planet under the pull of gravity, shielded from radiation by the magnetosphere and shaped by circadian rhythms due to Earth’s rotation on its axis. Once living beings leave such a protective environment, adaptive responses are activated to grant survival. In view of long manned mission out of Earth’s orbit, it is relevant to understand how humans adapt to space and if the responses activated might reveal detrimental in the long run. Here we review present knowledge about the effects on the vessels of various extraterrestrial factors on humans as well as in vivo and in vitro experimental models. It emerges that the vasculature activates complex adaptive responses finalized to supply oxygen and nutrients to all the tissues and to remove metabolic waste and carbon dioxide. Most studies point to oxidative stress and mitochondrial dysfunction as mediators of vascular alterations in space. Unraveling the cellular and molecular mechanisms involved in these adaptive processes might offer hints to design proper and personalized countermeasures to predict a safe future in space.

Effect of alpha-lipoic acid on arterial stiffness parameters in type 2 diabetes mellitus patients with cardiac autonomic neuropathy

Objective. Significantly underdiagnosed, diabetes-associated cardiac autonomic neuropathy (CAN) causes a wide range of cardiac disorders that may cause life-threatening outcomes. This study investigated the effects of alpha-lipoic acid (ALA) on arterial stiffness and insulin resistance (IR) parameters in type 2 diabetes mellitus (T2D) patients and definite CAN. Methods. A total of 36 patients with T2D and a definite stage of CAN were recruited. This investigation was carried out on two separate arms: traditional hypoglycemic therapy (n=18, control) and ALA (n=18) 600 mg in film-coated tablets/q.d. in addition to traditional hypoglycemic therapy. The duration of the study was three months. Results. In subjects with T2D and definite stage of СAN, treatment with ALA resulted in a significant decrease of glucose, immunoreactive insulin concentration, and Homeostasis Model Assessment (HOMA)-IR (HOMA-IR) parameters; pulse wave velocity (PWV), aorta augmentation index (AIxao) during the active period of the day and decrease of PWV, AIxao, and brachial augmentation index during the passive period of the day compared with the results, obtained in the control group. Therefore, the administration of ALA to patients with T2D for three months promotes the improvement of glucose metabolism and arterial stiffness parameters. Conclusions. In patients with T2D and definite stage of СAN treatment with ALA improved HOMA-IR and arterial stiffness parameters. These findings can be of clinical significance for the complex treatment of diabetes-associated CAN.

Carotid Atherosclerosis, Ultrasound and Lipoproteins

Carotid artery plaques are considered a measure of atherosclerosis and are associated with an increased risk of atherosclerotic cardiovascular disease, particularly ischemic strokes. Monitoring of patients with an elevated risk of stroke is critical in developing better prevention strategies. Non-invasive imaging allows us to directly see atherosclerosis in vessels and many features that are related to plaque vulnerability. A large body of evidence has demonstrated a strong correlation between some lipid parameters and carotid atherosclerosis. In this article, we review the relationship between lipids and atherosclerosis with a focus on carotid ultrasound, the most common method to estimate atherosclerotic load.