Drozdz Jarosølaw, Krzemińska-Pakuøla Maria, Lipiec Piotr, Orczykowski Michaøl, Chrzanowski Olukasz, Plewka Michaøl, Kasprzak Jarosølaw D
Department of Cardiology, Medical University of Lodz, Lodz, Poland.
J Am Soc Echocardiogr. 2005 Aug;18(8):789-94. doi: 10.1016/j.echo.2005.01.001.
Thickening of arterial intima and the presence of atherosclerotic plaques may influence vessel pulsation by increasing the wall stiffness. There are no data available concerning regional changes in aortic elasticity in relation with local wall thickness and the magnitude of atherosclerosis.
The study group comprised 48 patients (33 men, age 54 +/- 11 years) referred for transesophageal echocardiography. Reconstruction of 2-cm segments of aorta was divided by coaxial planes into 4 longitudinal sections. Thereafter, diastolic and systolic radius, thickness of atherosclerotic plaques, and intima-media thickness (IMT) in each section were measured. The relative change in regional aortic lumen (pulsation) was measured and regional beta-index was calculated. In total, 192 aortic sections were analyzed.
The volume of the examined sections of the aortic segments ranged from 0.6 to 4.1 cm3 (mean 1.6 +/- 0.7 cm3) in systole and from 0.5 to 3.7 cm3 (mean 1.4 +/- 0.7 cm3) in diastole. The pulsation of the aortic sections varied from 0.04 to 0.78 cm3 (mean 0.21 +/- 0.13 cm3), which constituted 1% to 21% (mean 6 +/- 4%) of the section volume. The thickness of atherosclerotic plaques in the studied aortic sections ranged from 0.03 to 1.87 mm (mean 0.31 +/- 0.26 mm) and IMT was within the range 1.28 to 3.61 mm (mean 1.87 +/- 0.39 mm). The regional beta-index of the individual section ranged from 1.6 to 97.1 (mean 12.5 +/- 14.6). The regional beta-index was statistically significantly dependent on the IMT (r = 0.43, P < .001), but not on the thickness of atherosclerotic plaques (P = .96). The variability of regional beta-index, defined as the difference between the highest and the lowest beta-index in the sections of the same aortic segment, ranged from 1.7 to 83.1 (mean 20.0 +/- 20.7) and was borderline correlated with the IMT (r = 0.26, P = .07), but not with the thickness of atherosclerotic plaques (P = .87).
Three-dimensional echocardiography facilitates quantitative analysis of aortic wall stiffness and regional beta-index measurements. The local aortic wall beta-index and its regional variability is dependent on IMT, but not on the thickness of atherosclerotic plaques.
动脉内膜增厚和动脉粥样硬化斑块的存在可能通过增加血管壁硬度来影响血管搏动。目前尚无关于主动脉弹性区域变化与局部管壁厚度及动脉粥样硬化程度之间关系的数据。
研究组包括48例接受经食管超声心动图检查的患者（33例男性，年龄54±11岁）。将2 cm长的主动脉节段重建后通过同轴平面分为4个纵向节段。然后，测量每个节段的舒张期和收缩期半径、动脉粥样硬化斑块厚度和内膜中层厚度（IMT）。测量主动脉区域管腔的相对变化（搏动）并计算区域β指数。总共分析了192个主动脉节段。
主动脉节段检查节段的体积在收缩期为0.6至4.1 cm³（平均1.6±0.7 cm³），舒张期为0.5至3.7 cm³（平均1.4±0.7 cm³）。主动脉节段的搏动范围为0.04至0.78 cm³（平均0.21±0.13 cm³），占节段体积的1%至21%（平均6±4%）。研究的主动脉节段中动脉粥样硬化斑块的厚度范围为0.03至1.87 mm（平均0.31±0.26 mm），IMT在1.28至3.61 mm范围内（平均1.87±0.39 mm）。各个节段的区域β指数范围为1.6至97.1（平均12.5±14.6）。区域β指数在统计学上显著依赖于IMT（r = 0.43，P <.001），但不依赖于动脉粥样硬化斑块的厚度（P =.96）。区域β指数的变异性定义为同一主动脉节段各节段中最高β指数与最低β指数之间的差异，范围为1.7至83.1（平均20.0±20.7），与IMT呈边缘相关性（r = 0.26，P =.07），但与动脉粥样硬化斑块厚度无关（P =.87）。
三维超声心动图有助于对主动脉壁硬度进行定量分析和区域β指数测量。局部主动脉壁β指数及其区域变异性取决于IMT，而不取决于动脉粥样硬化斑块的厚度。
