The Mechanism of Endothelial Dysfunction Formation in Young Patients With Spondylogenic Vertebrobasilar Insufficiency

Abstract

Objective: to determine the type of changes of shear stress in vessels of the vertebrobasilar system in patients of young age with spondylogenic vertebrobasilar insufficiency (SVI). Material and methods. We examined 131 patients (70 women and 61 men) aged 18-40 (average age was 29.8 ± 3.8) with manifestations of spondylogenic vertebrobasilar insufficiency associated with muscular reflex, neurovascular and radicular syndromes of osteochondrosis of the cervical part of the vertebral column. 25 healthy donors made the control group. All the patients underwent radiological examination of the cervical part of the vertebral column with functional probes, doppler and duplex ultrasound of vessels of the neck and arteries of the head with functional probes; we performed the detection of endothelin-1, nitric oxide (NO) of blood serum. The changes of the shear stress in vessels of the vertebrobasilar system were assessed analyzing the Stuart index (ISD), systolic and diastolic parameter. Results. It has been found that development of spondylogenic vertebrobasilar insufficiency is accompanied by signs of endothelial dysfunction (ED), which is characterized by increased concentration of endothelin-1 related to the reduction of active metabolite of nitrogen oxide - S-NO. One of the mechanisms of ED in this cohort of patients is changes of the shear stress. Conclusion. In order to predict the development of ED in patients with spondylogenic vertebrobasilar insufficiency, it is recommended to pay particular attention to the state of the vascular wall.

Diagnostic importance of phenotypic features of undifferentiated connective tissue dysplasia in spondylogenic vertebro-basilar insufficiency

“…The indicated CBM integrate the effect of phenotypic peculiarities and the formation of the risk of vascular disorders. The structural imbalance of cervical spine and the presence of (kyphosis/scoliosis) are the most informative and prognostically significant CBM of UCTD in SVBI patients (23).…”