Lind Lars, Andersson Jessika, Hansen Tomas, Johansson Lars, Ahlström Håkan
Departments of Medicine, Uppsala University Hospital, Uppsala 751 85, Sweden.
Clin Physiol Funct Imaging. 2009 Sep;29(5):321-9. doi: 10.1111/j.1475-097X.2009.00871.x. Epub 2009 May 20.
Arterial compliance and endothelium-dependent vasodilation are two characteristics of the vessel wall. In the Prospective Investigation of the Vasculature in Uppsala Seniors (PIVUS) study, we studied the relationships between arterial compliance and endothelium-dependent vasodilation versus atherosclerosis as measured with two imaging modalities.
In the population-based PIVUS study (1016 subjects aged 70), arterial compliance was determined by ultrasound in the carotid artery and the stroke volume to pulse pressure ratio by echocardiography, while endothelium-dependent vasodilation was assessed by the invasive forearm technique with acetylcholine and brachial artery ultrasound. Intima-media thickness was evaluated by ultrasound in the carotid artery (n = 954). Stenosis in the carotid, aorta, renal, upper and lower leg arteries were determined by magnetic resonance angiography in a random subsample of 306 subjects.
After adjustments for gender, Framingham risk score, obesity, myocardial infarction and stroke, distensibility in the carotid artery and the stroke volume to pulse pressure ratio were both significantly related to a weighted index of stenosis in the five arterial territories evaluated by magnetic resonance angiography (p<0.02 for both). Distensibility in the carotid artery (P = 0.021), but not the stroke volume to pulse pressure ratio (P = 0.08), was also significantly related to intima-media thickness.
In the elderly population, atherosclerosis is mainly related to arterial compliance, but not to endothelium-dependent vasodilation in peripheral conduit or resistance vessels.
动脉顺应性和内皮依赖性血管舒张是血管壁的两个特征。在乌普萨拉老年人血管系统前瞻性研究(PIVUS)中,我们研究了动脉顺应性和内皮依赖性血管舒张与通过两种成像方式测量的动脉粥样硬化之间的关系。
在基于人群的PIVUS研究(1016名70岁受试者)中,通过颈动脉超声测定动脉顺应性,通过超声心动图测定每搏输出量与脉压比值,而通过乙酰胆碱和肱动脉超声的侵入性前臂技术评估内皮依赖性血管舒张。通过颈动脉超声评估内膜中层厚度(n = 954)。在306名受试者的随机子样本中,通过磁共振血管造影确定颈动脉、主动脉、肾动脉、上下肢动脉的狭窄情况。
在对性别、弗雷明汉风险评分、肥胖、心肌梗死和中风进行调整后,颈动脉的扩张性和每搏输出量与脉压比值均与通过磁共振血管造影评估的五个动脉区域的加权狭窄指数显著相关(两者p<0.02)。颈动脉的扩张性(P = 0.021)与内膜中层厚度显著相关,但每搏输出量与脉压比值(P = 0.08)与内膜中层厚度无显著相关性。
在老年人群中,动脉粥样硬化主要与动脉顺应性有关,而与外周导管或阻力血管的内皮依赖性血管舒张无关。