Cheng Christopher P, Herfkens Robert J, Taylor Charles A
Department of Mechanical Engineering, Standford University, Stanford, CA, USA.
Atherosclerosis. 2003 Jun;168(2):323-31. doi: 10.1016/s0021-9150(03)00099-6.
The prevalence of atherosclerosis in the abdominal aorta increases with age and is hypothesized to be related to adverse hemodynamic conditions including flow recirculation and low wall shear stress. Exercise has been shown to modulate these adverse conditions observed in the infrarenal aorta of healthy young subjects at rest. A custom magnetic resonance (MR)-compatible stationary cycle, an open MRI, and custom image processing software were used to quantify hemodynamic conditions in the abdominal aorta at rest and during cycling exercise in healthy subjects aged 50-70 years. The subjects increased their heart rate from 63+/-8 bpm at rest to 95+/-12 bpm during cycling exercise. Supraceliac blood flow increased from 2.3+/-0.4 to 6.0+/-1.4 l/min (P<0.001) and infrarenal flow increased from 0.9+/-0.3 to 4.9+/-1.7 l/min (P<0.001) from rest to exercise. Wall shear stress increased from 2.0+/-0.7 to 7.3+/-2.4 dynes/cm(2) at the supraceliac level (P<0.001) and 1.4+/-0.8 to 16.5+/-5.1 dynes/cm(2) at the infrarenal level (P<0.001) from rest to exercise. Flow and shear oscillations present at rest were eliminated during exercise. At rest, these older subjects experienced lower mean wall shear stress at the supraceliac level of the aorta and greater oscillations in wall shear stress as compared to a group of younger subjects (23.6+/-2.2 years). Compared to the younger subjects, the older subjects also experienced greater increases in mean wall shear stress and greater decreases in wall shear stress oscillations from rest to exercise.
腹主动脉粥样硬化的患病率随年龄增长而增加,据推测与包括血流再循环和低壁面切应力在内的不良血流动力学状况有关。已有研究表明,运动可调节健康年轻受试者静息时在肾下腹主动脉观察到的这些不良状况。使用定制的与磁共振(MR)兼容的固定自行车、开放式MRI和定制图像处理软件,对50 - 70岁健康受试者静息时和骑行运动期间腹主动脉的血流动力学状况进行量化。受试者的心率从静息时的63±8次/分钟增加到骑行运动时的95±12次/分钟。从静息到运动,腹腔干上方血流量从2.3±0.4升/分钟增加到6.0±1.4升/分钟(P<0.001),肾下腹主动脉血流量从0.9±0.3升/分钟增加到4.9±1.7升/分钟(P<0.001)。壁面切应力在腹腔干上方水平从静息时的2.0±0.7达因/平方厘米增加到运动时的7.3±2.4达因/平方厘米(P<0.001),在肾下水平从1.4±0.8达因/平方厘米增加到16.5±5.1达因/平方厘米(P<0.001)。静息时出现的血流和切应力振荡在运动期间消失。与一组年轻受试者(23.6±2.2岁)相比,这些老年受试者在静息时主动脉腹腔干上方水平的平均壁面切应力较低,壁面切应力的振荡更大。与年轻受试者相比,老年受试者从静息到运动时平均壁面切应力的增加也更大,壁面切应力振荡的减少也更大。