Holaj R, Zelinka T, Wichterle D, Petrák O, Strauch B, Vránková A, Majtan B, Spácil J, Malík J, Widimský J
Third Medical Department, General Teaching Hospital and First Faculty of Medicine, Charles University in Prague, Prague, Czech Republic.
J Hum Hypertens. 2009 May;23(5):350-8. doi: 10.1038/jhh.2008.130. Epub 2008 Oct 30.
Catecholamines due to various mechanisms may contribute to the accumulation of collagen fibers and extracellular matrix in the arterial wall. The aim of this study was to compare intima-media thickness (IMT) of the common carotid artery (CCA) and carotid bifurcation (CB) in patients with pheochromocytoma, essential hypertension and healthy controls. Carotid ultrasound studies were carried out in 30 patients with pheochromocytoma matched for age and gender with 80 patients with essential hypertension and 40 normotensive controls. Significantly higher IMT was found in patients with pheochromocytoma and essential hypertension compared to controls when measured in the CCA (0.931+/-0.223, 0.825+/-0.146 and 0.738+/-0.113 mm; P<0.001; P<0.05), and only in patients with pheochromocytoma compared to controls in the region of CB (1.359+/-0.593, 1.095+/-0.311 and 0.968+/-0.247 mm; P<0.001; P=0.13). Higher IMT in patients with pheochromocytoma compared to patients with essential hypertension was also statistically significant in both carotid regions (both P<0.01). This difference remained significant after adjustment for all relevant clinical and biochemical covariates in the CCA (P=0.014) but disappeared in the region of CB (P=0.079). In summary, patients with pheochromocytoma have increased common carotid IMT when compared to patients with essential hypertension. This finding could be caused by the deleterious effects of the excess of catecholamines on the vascular wall growth and thickening.
由于各种机制，儿茶酚胺可能导致动脉壁中胶原纤维和细胞外基质的积累。本研究的目的是比较嗜铬细胞瘤患者、原发性高血压患者和健康对照者的颈总动脉（CCA）和颈动脉分叉处（CB）的内膜中层厚度（IMT）。对30例年龄和性别匹配的嗜铬细胞瘤患者、80例原发性高血压患者和40例血压正常的对照者进行了颈动脉超声检查。在CCA测量时，嗜铬细胞瘤患者和原发性高血压患者的IMT显著高于对照组（分别为0.931±0.223、0.825±0.146和0.738±0.113mm；P<0.001；P<0.05），而仅在CB区域，嗜铬细胞瘤患者的IMT高于对照组（分别为1.359±0.593、1.095±0.311和0.968±0.247mm；P<0.001；P=0.13）。在两个颈动脉区域，嗜铬细胞瘤患者的IMT高于原发性高血压患者也具有统计学意义（均P<0.01）。在CCA对所有相关临床和生化协变量进行调整后，这种差异仍然显著（P=0.014），但在CB区域消失（P=0.079）。总之，与原发性高血压患者相比，嗜铬细胞瘤患者的颈总动脉IMT增加。这一发现可能是由于过量儿茶酚胺对血管壁生长和增厚的有害影响所致。
