Ishida Sanemasa, Hamasaki Shuichi, Kamekou Masahiro, Yoshitama Takashi, Nakano Fumio, Yoshikawa Akiko, Kataoka Tetsuro, Saihara Keishi, Minagoe Shinichi, Tei Chuwa
First Department of Internal Medicine, Faculty of Medicine, Kagoshima University, 8-35-1 Sakuragaoka, Kagoshima 890-8520, Japan.
Coron Artery Dis. 2003 Sep;14(6):443-9. doi: 10.1097/00019501-200309000-00005.
Compensatory enlargement of the coronary arterial wall has been described in the early stages of native atherosclerosis. However, little is known about the specific effect of aging on this adaptive process in atherosclerosis. The purpose of the current study was to characterize the effects of advancing age on vascular remodeling and endothelium-dependent and -independent coronary vasodilation in patients without coronary artery disease risk factors.
Twenty-six patients without coronary risk factors and with normal and mildly diseased coronary arteries were studied. Vessel, lumen and atherosclerotic plaque areas were evaluated by intravascular ultrasound and coronary flow response was assessed using papaverine and acetylcholine in the left anterior descending coronary artery.
There was a weak but significant correlation between plaque area and age (r = 0.29, P<0.01). Vessel area was also weakly but significantly correlated with age (r = 0.22, P<0.05). However, lumen area had no correlation with age. Vessel area in the younger group (<50 years) and the older group (> or =50 years) increased 1.64 and 0.55 mm2 for every 1 mm2 increase in plaque area (r = 0.62, P<0.0001 and r = 0.39, P<0.05, respectively). With regard to vascular reactivity, there was an inverse correlation between the percentage increases in coronary blood flow (CBF) evoked by acetylcholine and aging (r = -0.49, P<0.05). The percentage increases in CBF evoked by papaverine also inversely correlated with aging (r=-0.53, P<0.01). However, the percentage changes in coronary artery diameter evoked with acetylcholine did not correlate with aging.
This study suggests that endothelium-dependent and -independent vasodilation of the resistance coronary artery are impaired with advancing age, which may be in association with attenuated coronary vascular remodeling with aging.
在原发性动脉粥样硬化早期已发现冠状动脉壁存在代偿性增大。然而，关于衰老对动脉粥样硬化这一适应性过程的具体影响，人们知之甚少。本研究的目的是明确在无冠状动脉疾病危险因素的患者中，年龄增长对血管重塑以及内皮依赖性和非依赖性冠状动脉舒张功能的影响。
对26例无冠状动脉危险因素且冠状动脉正常或轻度病变的患者进行研究。通过血管内超声评估血管、管腔和动脉粥样硬化斑块面积，并使用罂粟碱和乙酰胆碱评估左前降支冠状动脉的血流反应。
斑块面积与年龄之间存在微弱但显著的相关性（r = 0.29，P<0.01）。血管面积与年龄也存在微弱但显著的相关性（r = 0.22，P<0.05）。然而，管腔面积与年龄无相关性。对于较年轻组（<50岁）和较年长组（≥50岁），斑块面积每增加1平方毫米，血管面积分别增加1.64平方毫米和0.55平方毫米（r分别为0.62，P<0.0001和r = 0.39，P<0.05）。关于血管反应性，乙酰胆碱诱发的冠状动脉血流（CBF）增加百分比与衰老呈负相关（r = -0.49，P<0.05）。罂粟碱诱发的CBF增加百分比也与衰老呈负相关（r = -0.53，P<0.01）。然而，乙酰胆碱诱发的冠状动脉直径变化百分比与衰老无相关性。
本研究表明，随着年龄增长，阻力性冠状动脉的内皮依赖性和非依赖性舒张功能受损，这可能与衰老导致的冠状动脉血管重塑减弱有关。
