Ono S, Matsuzaki M, Michishige H, Wasaki Y, Tomochika Y, Murata K, Tokisawa I, Nishimura Y, Okuda F, Kusukawa R
Second Department of Internal Medicine, Yamaguchi University School of Medicine, Ube.
J Cardiol Suppl. 1991;26:57-67.
The thoracic aorta is one of the portions frequently involved with atherosclerotic lesions. We estimated atherosclerotic lesions in the thoracic aorta in consecutive 137 patients (59 +/- 10 years old) using transesophageal echocardiography. The study population consisted of 60 with coronary artery disease (CAD), 36 with hypertension (HT), 28 with hypercholesterolemia (HC, total cholesterol greater than or equal to 230 mg/dl), eight with dissecting aneurysm, nine with true aneurysm and two with aortitis syndrome. We used a single transverse scan-plane probe with ultrasound frequency of 5 MHz. We could obtain satisfactory echograms of whole thoracic aorta except upper portion of the ascending aorta. We defined atherosclerotic lesions as an increased echo-density of the intima, protruded plaque, ulceration or aneurysm. Atherosclerotic lesions were observed in 71 of 137 patients (52%). High incidence of the atherosclerotic lesions was seen in patients with HT (72%), HC (57%) and CAD (57%), whereas incidence of atherosclerotic lesions was low (15%) in patients without HT, HC, CAD or aortic aneurysm. Atherosclerotic lesions were observed more frequently in patients aged greater than or equal to 60 years (69% vs 34%, p less than 0.001). In patients with HT or HC, atherosclerotic lesions were frequently observed even in patients younger than 60 years old (HT: 58%, HC: 53%). We concluded that HT, HC and aging were important risk factors for the atherosclerotic process in the thoracic aorta, and transesophageal echocardiography was a useful approach for the detailed estimation of atherosclerotic lesions in the thoracic aorta.
胸主动脉是动脉粥样硬化病变常累及的部位之一。我们使用经食管超声心动图对连续137例患者（年龄59±10岁）的胸主动脉粥样硬化病变进行了评估。研究人群包括60例冠心病（CAD）患者、36例高血压（HT）患者、28例高胆固醇血症（HC，总胆固醇≥230mg/dl）患者、8例夹层动脉瘤患者、9例真性动脉瘤患者和2例主动脉炎综合征患者。我们使用了一个超声频率为5MHz的单平面横向扫描探头。除升主动脉上部外，我们能够获得整个胸主动脉的满意超声心动图。我们将动脉粥样硬化病变定义为内膜回声密度增加、斑块突出、溃疡或动脉瘤。137例患者中有71例（52%）观察到动脉粥样硬化病变。HT患者（72%）、HC患者（57%）和CAD患者（57%）的动脉粥样硬化病变发生率较高，而无HT、HC、CAD或主动脉瘤的患者动脉粥样硬化病变发生率较低（15%）。年龄≥60岁的患者动脉粥样硬化病变观察更为频繁（69%对34%，p<0.001）。在HT或HC患者中，即使在60岁以下的患者中也经常观察到动脉粥样硬化病变（HT：58%，HC：53%）。我们得出结论，HT、HC和衰老都是胸主动脉粥样硬化进程的重要危险因素，经食管超声心动图是详细评估胸主动脉粥样硬化病变的一种有用方法。
