Department of Epidemiology and Medicine, Johns Hopkins Bloomberg School of Public Health and the Johns Hopkins University School of Medicine, Baltimore, MD, USA.
Atherosclerosis. 2010 Jan;208(1):69-74. doi: 10.1016/j.atherosclerosis.2009.06.025. Epub 2009 Jun 26.
Medial vascular fibrosis contributes to arterial stiffening and reduced compliance, increasing the risk of cardiovascular events. We undertook the first comprehensive histopathologic study of medium-to-large caliber blood vessels (carotid, coronary, dorsalis pedis, internal mammary, iliac, mesenteric, pulmonary, and renal arteries) in 100 autopsy subjects to characterize medial fibrosis in relation to cardiovascular risk factors.
Masson Trichrome staining of vascular tissue microarrays (TMAs) was digitally analyzed to determine the percent fibrosis (% collagen) of over 700 vascular segments. The percent fibrosis of the tunica media was strongly correlated within subjects across all systemic blood vessels (average r=0.53), suggesting that fibrosis is a global process independent of the predilection of the vessel towards the development of atherosclerosis. Hypertension, diabetes, age and poor renal function were significantly associated with increased systemic vascular fibrosis (p< or =0.03). By multivariable analysis, only poor renal function (p=0.003) was an independent predictor of higher levels of fibrosis. Finally, in a subset of 13 individuals we observed a significant correlation between pre-mortem pulse pressure and systemic vascular fibrosis (p<0.001).
This study demonstrates that vascular fibrosis is a global process associated with diseases of aging and elevated pulse pressures.
血管中层纤维化导致动脉僵硬和顺应性降低，增加心血管事件的风险。我们对 100 例尸检标本的中到大口径血管（颈动脉、冠状动脉、足背动脉、内乳动脉、髂动脉、肠系膜动脉、肺动脉和肾动脉）进行了首次全面的组织病理学研究，以确定与心血管危险因素相关的中层纤维化。
血管组织微阵列（TMA）的 Masson 三色染色进行数字化分析，以确定超过 700 个血管段的纤维化百分比（%胶原）。在所有系统性血管中，跨受试者的中膜纤维化百分比具有很强的相关性（平均 r=0.53），这表明纤维化是一种全身性过程，与血管发生动脉粥样硬化的倾向无关。高血压、糖尿病、年龄和肾功能不良与系统性血管纤维化增加显著相关（p<或=0.03）。通过多变量分析，只有肾功能不良（p=0.003）是纤维化程度更高的独立预测因素。最后，在 13 名个体的亚组中，我们观察到生前脉压与系统性血管纤维化之间存在显著相关性（p<0.001）。
这项研究表明，血管纤维化是一种与衰老疾病和升高的脉压相关的全身性过程。
