年轻吸烟者肱动脉、颈动脉和主动脉血管功能的整体损害：通过高分辨率磁共振成像直接定量分析。

Global impairment of brachial, carotid, and aortic vascular function in young smokers: direct quantification by high-resolution magnetic resonance imaging.

作者信息

Wiesmann Frank, Petersen Steffen E, Leeson Paul M, Francis Jane M, Robson Matthew D, Wang Qian, Choudhury Robin, Channon Keith M, Neubauer Stefan

机构信息

University of Oxford Centre for Clinical Magnetic Resonance Research, Department of Cardiovascular Medicine, University of Oxford, Oxford, United Kingdom.

出版信息

J Am Coll Cardiol. 2004 Nov 16;44(10):2056-64. doi: 10.1016/j.jacc.2004.08.033.

DOI:10.1016/j.jacc.2004.08.033

PMID:15542292

Abstract

OBJECTIVES

The purpose of this study was to assess vascular dysfunction in young smokers by high-resolution magnetic resonance imaging (MRI).

BACKGROUND

Cigarette smoking is a well-known cause of endothelial dysfunction, reflected by impaired brachial artery reactivity to hyperemia. We hypothesized that smoking induces both peripheral endothelial dysfunction and altered function in central conduit arteries, and that these global changes in vascular function could be directly quantified in a single noninvasive examination using high-resolution MRI.

METHODS

A total of 22 healthy young volunteers (mean age 31 +/- 2 years; 12 nonsmokers, 10 smokers: cumulative cigarette consumption 11.9 +/- 6.0 pack-years) underwent noninvasive high-resolution MRI to assess central vascular distensibility and pulse-wave velocity (PWV), and cross-sectional flow-mediated dilation (FMD) of the brachial artery.

RESULTS

Brachial artery FMD was significantly reduced in smokers compared with nonsmokers (7.5 +/- 2.7% vs. 15.5 +/- 2.0%; p = 0.03), indicating impaired endothelium-dependant relaxation, whereas endothelium-independent responses to sublingual glyceroltrinitrate(400 mug) were identical in both groups. Impaired peripheral endothelial function in smokers was accompanied by striking decreases in central vascular distensibility in both the common carotid arteries (-45.7%; p = 0.02) and at multiple sites in the aorta (ascending aorta -26.9%, p = 0.04; thoracic descending aorta -25.0%, p = 0.01; abdominal descending aorta -25.5%, p = 0.02). Aortic arch PWV in smokers was increased by 19% (p = 0.02).

CONCLUSIONS

Cigarette smoking induces global changes in both peripheral and central vascular function. Direct quantification of multiple parameters of vascular function using high-resolution MRI will provide powerful new approaches to the assessment of vascular disease pathogenesis, diagnosis, and treatment.

摘要

目的

本研究旨在通过高分辨率磁共振成像（MRI）评估年轻吸烟者的血管功能障碍。

背景

吸烟是内皮功能障碍的一个众所周知的原因，表现为肱动脉对充血反应性受损。我们假设吸烟会导致外周内皮功能障碍以及中央输送动脉功能改变，并且这些血管功能的整体变化可以通过使用高分辨率MRI的单一非侵入性检查直接量化。

方法

共有22名健康年轻志愿者（平均年龄31±2岁；12名非吸烟者，10名吸烟者：累积吸烟量11.9±6.0包年）接受了非侵入性高分辨率MRI检查，以评估中央血管扩张性和脉搏波速度（PWV），以及肱动脉的横断面血流介导的扩张（FMD）。

结果

与非吸烟者相比，吸烟者的肱动脉FMD显著降低（7.5±2.7%对15.5±2.0%；p = 0.03），表明内皮依赖性舒张受损，而两组对舌下硝酸甘油（400μg）的非内皮依赖性反应相同。吸烟者外周内皮功能受损伴随着颈总动脉（-45.7%；p = 0.02）和主动脉多个部位（升主动脉-26.9%，p = 0.04；胸降主动脉-25.0%，p = 0.01；腹降主动脉-25.5%，p = 0.02）中央血管扩张性的显著降低。吸烟者的主动脉弓PWV增加了19%（p = 0.02）。