Nemes Attila, Forster Tamás, Csanády Miklós, Gruber Noémi
2nd Department of Medicine and Cardiology Center, Medical Faculty, Albert Szent-Györgyi Medical and Pharmaceutical Center, University of Szeged, Hungary.
Int J Cardiovasc Imaging. 2004 Aug;20(4):271-7. doi: 10.1023/b:caim.0000041935.28173.55.
The purpose of this study was to evaluate the correlation of the elastic properties of the descending aorta, the coronary flow velocity reserve (CFR) and the grade of aortic atherosclerosis (AA) in patients who have undergone coronary angiography.
A total of 113 consecutive patients (77 men and 36 women, aged 31-80 years) underwent stress transoesophageal echocardiographic (STEE) assessment of the CFR. The grade of AA and the indices of aortic distensibility were evaluated during the same session of STEE. All patients had chest pain without previous myocardial infarction. Coronary angiography was performed in all cases.
The resting systolic and diastolic coronary flow velocities increased, while the coronary flow velocities measured at the peak of stress and the ratio Smax/Srest decreased in parallel with the aortic grade. The CFR and mean CFR were impaired in patients who exhibited aortic intimal thickening, but no further decrease was found in the event of aortic plaque. The elastic moduli E(p) and E(s) increased in parallel with the grade of AA. The occurance of a negative coronary angiogram was more common in patients without AA, but significant left anterior descending coronary artery disease or multivessel disease were more frequent at a higher grade of AA (in cases with aortic plaque).
The CFR was decreased in patients with aortic intimal thickening, but no further decrease was observed in the presence of aortic plaque. The indices of aortic distensibility increased continuously in parallel with the aortic grade.
本研究旨在评估接受冠状动脉造影的患者降主动脉弹性特性、冠状动脉血流储备（CFR）与主动脉粥样硬化（AA）分级之间的相关性。
连续113例患者（77例男性和36例女性，年龄31 - 80岁）接受了CFR的经食管超声心动图负荷试验（STEE）评估。在同一次STEE检查期间评估AA分级和主动脉扩张性指标。所有患者均有胸痛症状且既往无心肌梗死病史。所有病例均进行了冠状动脉造影。
静息时的收缩期和舒张期冠状动脉血流速度增加，而负荷峰值时测量的冠状动脉血流速度以及Smax/Srest比值随主动脉分级平行下降。在出现主动脉内膜增厚的患者中CFR和平均CFR受损，但在有主动脉斑块的情况下未发现进一步下降。弹性模量E(p)和E(s)随AA分级平行增加。冠状动脉造影阴性在无AA的患者中更常见，但在较高AA分级（有主动脉斑块的病例）中显著的左前降支冠状动脉疾病或多支血管疾病更频繁。
主动脉内膜增厚的患者CFR降低，但在有主动脉斑块的情况下未观察到进一步下降。主动脉扩张性指标随主动脉分级持续增加。
