K. Hristova 1, L. Vladimirova 2, F. Nikolov 2, P. Nikolov 2, Tz. Katova 1
1 National Heart Hospital – Sofia,
2 Medical University – Sofia, Bulgaria

Objective: To study the relationship between carotid pathology and exercise stress-test in patients with new onset symptoms for cardiovascular diseases (CVDs).

Material and Methods: Exercise stress-test (EST) and echocardiography were performed in 503 patients (mean age 54±17 years) with symptoms for CVD in two cardiological centers. Based on EST the patients were classified in three groups - with positive, negative or questionable results. Color duplex sonography of both carotid arteries was performed in transverse and longitudinal planes and intima media thickness (IMT) of the common carotid (CCA) and internal carotid (ICA) arteries was measured. No modifiable (age and sex) and some modifiable (hypertension, diabetes, atrial fibrillation, dyslipidemia, carotid stenosis, obesity, hemorheological variables – leucocytes (Leuc) hemoglobin (Hb), hematocrit (Ht), FR for CVD were evaluated. The pts with positive EST were on PTCA undergone and pts with questionable EST the decision for PTCA was taken after severity of carotid pathology and clinical exam.

S. Andonova-Atanasova 1, D. Petkova 2, M. Novakova 3, R. Georgiev 3
1 Department of Neurology, Second Clinic of Neurology,
2 Clinic of Pneumology and Phtisiology,
3 Department of Radiology, University Hospital St Marina – Varna, Bulgaria

Objective: To evaluate the change of intima-media thickness of the carotid artery in patients suffering by obstructive sleep apnea (OSAS) and asymptomatic ischemic disturbances of cerebral circulation.

Materials and Methods: The participants of the study are divided into 2 groups: 12 patients suffering from OSAS and asymptomatic ischemic disturbances of cerebral circulation (mean age 50.7±8.4 years), and a control group of 10 participants (mean age 50.4±8.4 years), having risk factors (RF) for cerebrovascular diseases (CVD) and asymptomatic ischemic disturbances of cerebral circulation but not OSAS. The morphology of the artery wall – the thickness of the intima media complex (IMT) of the common carotid arteries (CCA), the presence of atherosclerotic plaques, their magnitude, echogenicity and stability- are determined by a color-coded duplex sonography of the main arteries of the head.

Y. Kim 1, J-H. Lee 2, W-G. Seo 3, S-U. Kwon 4
1 Ewha Womans University Mokdong Hospital – Seoul, Korea,
2 NHIS Ilsan Hospital – Ilsan, Korea,
3 Korea University Guro Hospital – Seoul, Korea,
4 Ulsan University Asan Medical Center – Seoul, Korea

Objective: It is reported that the occurrence of cerebral hemorrhage tends to increase in cases of accompanying lacunar infarction which occurs more frequently in Asians than in Westerners, or periventricular ischemic change which increasingly occurs with ageing. Accordingly, the point is that the occurrence of cerebral hemorrhage should be primarily considered in the treatment of cerebral infarction, along with the phenomenon of an ageing population both in Asian countries including Korea. Nevertheless, so far there has been no clinical research regarding secondary prevention of stroke, particularly considering the risk of occurrence of hemorrhage in cerebral infarction cases. However, according to a recent study, when phosphodiesterase inhibitors including cilostazol are used independently, or in combination with aspirin, secondary prevention can be improved without increasing the occurrence of hemorrhagic side effects.