动脉粥样硬化无创预测指标之间的相互关系：经胸冠状动脉血流储备、血流介导的血管舒张功能、颈动脉内膜中层厚度、主动脉僵硬度、主动脉扩张性、弹性模量和肱动脉直径。

Interrelationship between noninvasive predictors of atherosclerosis: transthoracic coronary flow reserve, flow-mediated dilation, carotid intima-media thickness, aortic stiffness, aortic distensibility, elastic modulus, and brachial artery diameter.

作者信息

Gullu Hakan, Erdogan Dogan, Caliskan Mustafa, Tok Derya, Yildirim Erkan, Ulus Taner, Turan Sezgin Alpay, Muderrisoglu Haldun

机构信息

Konya Teaching and Medical Research Center, Cardiology Department, Baskent University, Konya, Turkey.

出版信息

Echocardiography. 2006 Nov;23(10):835-42. doi: 10.1111/j.1540-8175.2006.00342.x.

DOI:10.1111/j.1540-8175.2006.00342.x

PMID:17069601

Abstract

BACKGROUND

In this study, we searched for a correlation between transthoracic coronary flow reserve (CFR) and well-established surrogates of coronary atherosclerosis.

METHODS

The study was conducted on 136 healthy subjects (mean age: 39.9 +/- 7.3 years) who were free of coronary risk factors. Transthoracic echocardiography was used to measure the aortic stiffness index (AoSI), aortic distensibility (AoD), and aortic elastic modulus (AoEM). High-resolution ultrasound was used to measure brachial artery endothelium-dependent and independent vasomotion and carotid intima-media thickness (IMT). In addition, transthoracic second harmonic Doppler echocardiography was used to measure CFR.

RESULTS

All of the parameters significantly correlated with each other except brachial endothelium-independent dilation. CFR correlated significantly with brachial endothelium-dependent dilation (EDD) (r = 0.302, P < 0.01), carotid IMT (r =-0.388, P < 0.01), brachial artery diameter (r = 0.340, P < 0.01), AoD (r = 0.275, P < 0.01), AoS (r =-0.299, P < 0.01), and AoEM (r =-0.30,7 P < 0.01). Carotid IMT correlated significantly with brachial EDD and modestly with brachial artery diameter, AoD, AoS, and AoEM.In multivariate analysis, carotid IMT (beta=-0.323, P < 0.0001) and brachial artery diameter (beta = -0.259, P = 0.001) were significant independent predictors of CFR. The left ventricular mass index (beta= 0.371, P < 0.0001), brachial EDD (beta = -0.232, P = 0.002), and CFR (beta = -0.228, P = 0.003) were significant predictors for IMT.

CONCLUSION

Transthoracic CFR correlated significantly with well-established noninvasive predictors of atherosclerosis, and we suggest that it can be used as a surrogate for coronary atherosclerosis.

摘要

背景

在本研究中，我们探寻经胸冠状动脉血流储备（CFR）与已确立的冠状动脉粥样硬化替代指标之间的相关性。

方法

本研究对136名无冠状动脉危险因素的健康受试者（平均年龄：39.9±7.3岁）进行。采用经胸超声心动图测量主动脉僵硬度指数（AoSI）、主动脉扩张性（AoD）和主动脉弹性模量（AoEM）。采用高分辨率超声测量肱动脉内皮依赖性和非依赖性血管运动以及颈动脉内膜中层厚度（IMT）。此外，采用经胸二次谐波多普勒超声心动图测量CFR。

结果

除肱动脉非内皮依赖性扩张外，所有参数之间均显著相关。CFR与肱动脉内皮依赖性扩张（EDD）显著相关（r = 0.302，P < 0.01）、与颈动脉IMT显著相关（r = -0.388，P < 0.01）、与肱动脉直径显著相关（r = 0.340，P < 0.01）、与AoD显著相关（r = 0.275，P < 0.01）、与AoS显著相关（r = -0.299，P < 0.01）以及与AoEM显著相关（r = -0.307，P < 0.01）。颈动脉IMT与肱动脉EDD显著相关，与肱动脉直径、AoD、AoS和AoEM呈中度相关。在多变量分析中，颈动脉IMT（β = -0.323，P < 0.0001）和肱动脉直径（β = -0.259，P = 0.001）是CFR的显著独立预测因素。左心室质量指数（β = 0.371，P < 0.0001）、肱动脉EDD（β = -0.232，P = 0.002）和CFR（β = -0.228，P = 0.003）是IMT的显著预测因素。