原发性淀粉样变性中的血管异常。

Vascular abnormalities in primary amyloidosis.

作者信息

Modesto Karen M, Dispenzieri Angela, Gertz Morie, Cauduro Sanderson A, Khandheria Bijoy K, Seward James B, Kyle Robert, Wood Christina M, Bailey Kent R, Tajik Abdel Jamil, Miller Fletcher A, Pellikka Patricia A, Abraham Theodore P

机构信息

Division of Cardiovascular Diseases, Mayo Clinic, Rochester, MN, USA.

出版信息

Eur Heart J. 2007 Apr;28(8):1019-24. doi: 10.1093/eurheartj/ehm066. Epub 2007 Apr 12.

DOI:10.1093/eurheartj/ehm066

PMID:17430997

Abstract

AIMS

Primary amyloidosis (AL) is a systemic disease; however, there is limited information regarding the presence and character of vascular abnormalities.

METHODS AND RESULTS

Validated ultrasound techniques were used to prospectively determine carotid artery intimal-medial thickness (IMT) and brachial artery flow-mediated dilatation (FMD) in 59 consecutive AL patients and 17 age-similar, healthy, asymptomatic volunteers (CON). Carotid IMT was increased in AL when compared with CON (0.07 +/- 0.02 vs. 0.04 +/- 0.01 mm, P < 0.01). Similarly, brachial artery FMD was significantly lower in AL when compared with CON subjects (3 +/- 7 vs. 12 +/- 8%, P < 0.01). Multivariable analysis revealed that AL was associated with larger IMT and lower FMD after controlling for several confounding variables. However, within AL cases, there was not a significant association of cardiac vs. non-cardiac involvement with IMT or FMD (P = 0.1 and 0.2, respectively).

CONCLUSION

AL is associated with abnormal vascular morphology and endothelial dysfunction. Vascular abnormalities do not appear to be related to echocardiographic evidence of cardiac involvement.

摘要

目的

原发性淀粉样变性（AL）是一种全身性疾病；然而，关于血管异常的存在和特征的信息有限。

方法与结果

采用经过验证的超声技术，对59例连续的AL患者和17名年龄相仿、健康、无症状的志愿者（对照组）进行前瞻性测定颈动脉内膜中层厚度（IMT）和肱动脉血流介导的扩张（FMD）。与对照组相比，AL患者的颈动脉IMT增加（0.07±0.02对0.04±0.01mm，P<0.01）。同样，与对照组相比，AL患者的肱动脉FMD显著降低（3±7对12±8%，P<0.01）。多变量分析显示，在控制了几个混杂变量后，AL与较大的IMT和较低的FMD相关。然而，在AL病例中，心脏受累与非心脏受累与IMT或FMD之间没有显著关联（分别为P=0.1和0.2）。