Schmidt Caroline, Fagerberg Björn, Hulthe Johannes
The Wallenberg Laboratory for Cardiovascular Research, Sahlgrenska University Hospital, Göteborg University, Sweden.
Atherosclerosis. 2005 Jul;181(1):125-30. doi: 10.1016/j.atherosclerosis.2004.12.034.
The aim of the present study was to examine the relationship between plaque occurrence, plaque size and plaque echogenicity, assessed by B-mode ultrasound, in the femoral artery and the development of clinical cardiovascular disease.
The relationship between carotid atherosclerosis assessed by B-mode ultrasound and cardiovascular disease has been thoroughly investigated. In comparison, the femoral arteries have received much less attention.
The femoral artery was examined by high-resolution B-mode ultrasound in 391, 58-year-old men identified by screening in the city of Goteborg, Sweden. Assessment of plaque occurrence, plaque size (no, small, or moderate/large) and plaque characteristics in terms of echogenicity (no, echogenic or echolucent) were performed.
Subjects with a plaque present in the femoral artery at study baseline had a three-fold increase in odds ratio (OR 3.04, 95%, CI 1.24-7.42) for having a cardiovascular event during 6.6 years of follow-up compared to subjects without plaque. After adjustment for cardiovascular risk factors (LDL, triglycerides, systolic blood pressure and smoking) there was a borderline significant association between plaque occurrence and cardiovascular disease (OR = 2.64, p = 0.055). Plaque size could be demonstrated to be associated with cardiovascular events (p = 0.012, for trend). The results also showed that in this group of men, the risk of having a cardiovascular event was to a large extent confined to those with an echolucent plaque at baseline. However, no significant difference in risk prediction was seen between echogenic and echolucent plaques, respectively.
This is the first study to show that the presence of non-stenotic plaques in the femoral artery in middle-aged men without prior cardiovascular events has a predictive value for future cardiovascular events. The relationship was attenuated by adjustment for traditional cardiovascular risk factors. Data also indicates that plaque echolucency predicts increased risk.
本研究旨在通过B超评估股动脉斑块的发生情况、大小及回声性，并研究其与临床心血管疾病发生发展之间的关系。
通过B超评估颈动脉粥样硬化与心血管疾病之间的关系已得到充分研究。相比之下，股动脉受到的关注要少得多。
在瑞典哥德堡市通过筛查确定了391名58岁男性，用高分辨率B超对其股动脉进行检查。评估斑块的发生情况、大小（无、小或中/大）以及回声特征（无、回声或无回声）。
在研究基线时股动脉存在斑块的受试者，与无斑块受试者相比，在6.6年的随访期间发生心血管事件的比值比增加了两倍（比值比3.04，95%可信区间1.24 - 7.42）。在调整心血管危险因素（低密度脂蛋白、甘油三酯、收缩压和吸烟）后，斑块发生与心血管疾病之间存在临界显著关联（比值比 = 2.64，p = 0.055）。斑块大小与心血管事件相关（趋势p = 0.012）。结果还表明，在这组男性中，发生心血管事件的风险在很大程度上局限于基线时有无回声斑块的人群。然而，回声斑块和无回声斑块在风险预测方面没有显著差异。
这是第一项表明在无心血管事件病史的中年男性中，股动脉非狭窄斑块的存在对未来心血管事件具有预测价值的研究。这种关系在调整传统心血管危险因素后减弱。数据还表明斑块的无回声性预示着风险增加。
