Kaymaz Cihangir, Ozdemir Nihal, Kirma Cevat, Ozkan Mehmet
Department of Cardiology, Koşuyolu Heart and Research Hospital, Kadiköy, 81020 Istanbul, Turkey.
Int J Cardiol. 2003 Aug;90(2-3):147-52. doi: 10.1016/s0167-5273(02)00150-x.
The objective of the study was to evaluate the frequency, clinical and echocardiographic correlates of spontaneous echo contrast in the descending aorta in the absence of dissection. Prevalence of spontaneous echo contrast in the descending aorta in the absence of dissection, and its clinical and echocardiographic correlates were investigated in 1199 consecutive patients who underwent transesophageal echocardiography. Spontaneous echo contrast in the descending aorta was detected in 54 (4.5%) patients. Patients with spontaneous echo contrast in the descending aorta had an older age (60.6+/-8 vs. 40.6+/-14.2 years, P=0.0001), an increased prevalence of male gender (66.7 vs. 43.9%, P=0.001), an increased diameter of ascending aorta (4.2+/-1.0 vs. 3.3+/-1.1 cm, P=0.0001), an increased diameter of descending aorta (3.1+/-0.9 vs. 2.1+/-0.4 cm, P=0.0001), a higher prevalence of aortic wall calcification (9.3 vs. 0.5%, P=0.00001), complex plaque in the descending aorta (13 vs. 0.7%, P=0.0001), left ventricular dysfunction (7.4 vs. 2.1%, P<0.05), a lower incidence of severe aortic regurgitation (0 vs. 3.5%, P<0.05), a lower peak flow velocity in the descending aorta (28+/-9 vs. 51+/-21 cm/s, P<0.00001), and a lower maximal shear rate in the descending aorta (51+/-29 vs. 105+/-47 s(-1), P<0.00001) compared with patients without spontaneous echo contrast in the descending aorta. However, prevalence of atrial fibrillation, mitral valve disease, intracardiac spontaneous echo contrast and/or thrombus and embolic event were not different between patients with and without spontaneous echo contrast in the descending aorta (P>0.05). Shear rate, diameter of the descending aorta, aortic wall calcification, complex plaque in the descending aorta, absence of severe aortic regurgitation and male gender were independent variables of spontaneous echo contrast in the descending aorta. Spontaneous echo contrast in the descending aorta is a local and flow-dependent phenomenon related to aortic dilation, atherosclerosis, and decreased shear rates in the descending aorta. However, in this study, spontaneous echo contrast in the descending aorta was not found to be associated with embolic events.
本研究的目的是评估在无夹层的情况下降主动脉内自发显影的频率、临床及超声心动图相关因素。在1199例连续接受经食管超声心动图检查的患者中，研究了无夹层时降主动脉内自发显影的发生率及其临床和超声心动图相关因素。在54例（4.5%）患者中检测到降主动脉内自发显影。降主动脉内有自发显影的患者年龄较大（60.6±8岁 vs. 40.6±14.2岁，P = 0.0001），男性患病率增加（66.7% vs. 43.9%，P = 0.001），升主动脉直径增大（4.2±1.0 cm vs. 3.3±1.1 cm，P = 0.0001），降主动脉直径增大（3.1±0.9 cm vs. 2.1±0.4 cm，P = 0.0001），主动脉壁钙化患病率更高（9.3% vs. 0.5%，P = 0.00001），降主动脉内复杂斑块患病率更高（13% vs. 0.7%，P = 0.0001），左心室功能障碍患病率更高（7.4% vs. 2.1%，P<0.05），重度主动脉瓣反流发生率更低（0% vs. 3.5%，P<0.05），降主动脉内峰值流速更低（28±9 cm/s vs. 51±21 cm/s，P<0.00001），降主动脉内最大剪切率更低（51±29 s⁻¹ vs. 105±47 s⁻¹，P<0.00001），与降主动脉内无自发显影的患者相比。然而，降主动脉内有或无自发显影的患者之间房颤、二尖瓣疾病、心内自发显影和/或血栓以及栓塞事件的患病率并无差异（P>0.05）。剪切率、降主动脉直径、主动脉壁钙化、降主动脉内复杂斑块、无重度主动脉瓣反流以及男性性别是降主动脉内自发显影的独立变量。降主动脉内自发显影是一种与主动脉扩张、动脉粥样硬化以及降主动脉内剪切率降低相关的局部且与血流有关的现象。然而，在本研究中，未发现降主动脉内自发显影与栓塞事件相关。
