Labropoulos N, Ashraf Mansour M, Kang S S, Oh D S, Buckman J, Baker W H
Department of Surgery, Loyola University Medical Center, Maywood, IL 60153-3304, USA.
Eur J Vasc Endovasc Surg. 2000 Mar;19(3):221-5. doi: 10.1053/ejvs.1999.1008.
remodelling of the arterial wall occurs with ageing, even in the absence of atherosclerotic risk factors. With increasing age, arteries dilate, thicken, and get stiffer. The aim of this study was to correlate carotid artery stiffness with wall thickness and plaque presence between healthy individuals and patients with early and advanced atherosclerosis.
twenty healthy volunteers, 40 carotid segments and 90 patients, 174 carotid segments, with vascular disease were included in the study. The carotid artery was imaged longitudinally and measurements of the intimal-medial thickness (IMT) and plaque were obtained. Systolic and diastolic blood pressures were taken from each arm. The carotid artery stiffness (pressure-strain elastic modulus, Ep) was calculated in all sites from the changes in pressure and diameter. M-mode was used to detect the diameter change (systolic to diastolic) over five cardiac cycles.
in the healthy volunteers there was no evidence of plaque or increased IMT. The mean IMT was significantly higher in the patients compared to control (0.83+/-0.27 mm vs. 0.54+/-0.08 mm, p <0.0001). The IMT had a poor correlation with Ep at lower thickness (r=0.24, p=0.08) but this association became stronger with increasing thickness (r=0.62, p<0.001). Arterial segments with an IMT 5 0.88 mm became significantly stiffer compared to the controls (p<0.001) and to patients with an IMT<0.88 mm (p <0.01). Carotid Ep was markedly greater in arterial segments with plaques than in those with increased IMT (p <0.001) and the controls (p<0.0001).
carotid wall areas with small increase in IMT have a poor correlation with carotid artery stiffness. The carotid stiffness increases in areas with marked wall thickening and particularly in segments with plaque. The simultaneous study of vessel-wall elastic behaviour with IMT and plaque changes may increase our understanding of atherosclerotic progression and wall remodelling.
即使在没有动脉粥样硬化风险因素的情况下，动脉壁重塑也会随着年龄增长而发生。随着年龄的增加，动脉会扩张、增厚并变得更僵硬。本研究的目的是比较健康个体以及早期和晚期动脉粥样硬化患者的颈动脉僵硬度与管壁厚度和斑块存在情况之间的关系。
本研究纳入了20名健康志愿者（40个颈动脉节段）和90名患有血管疾病的患者（174个颈动脉节段）。对颈动脉进行纵向成像，并测量内膜中层厚度（IMT）和斑块情况。测量每只手臂的收缩压和舒张压。根据压力和直径的变化计算所有部位的颈动脉僵硬度（压力应变弹性模量，Ep）。使用M型超声检测五个心动周期内的直径变化（收缩期至舒张期）。
在健康志愿者中，没有斑块或IMT增加的证据。与对照组相比，患者的平均IMT显著更高（0.83±0.27mm对0.54±0.08mm，p<0.0001）。在较低厚度时，IMT与Ep的相关性较差（r=0.24，p=0.08），但随着厚度增加，这种关联变得更强（r=0.62，p<0.001）。与对照组相比（p<0.001）以及与IMT<0.88mm的患者相比（p<0.01），IMT≥0.88mm的动脉节段变得明显更僵硬。有斑块的动脉节段的颈动脉Ep明显大于IMT增加的节段（p<0.001）和对照组（p<0.0001）。
IMT略有增加的颈动脉壁区域与颈动脉僵硬度的相关性较差。颈动脉僵硬度在管壁明显增厚的区域增加，特别是在有斑块的节段。同时研究血管壁弹性行为与IMT和斑块变化可能会增加我们对动脉粥样硬化进展和管壁重塑的理解。
