Lanza G M, Zabalgoitia-Reyes M, Frazin L, Meyers S N, Spitzzeri C L, Vonesh M J, Mehlman D J, Talano J V, McPherson D D
Department of Internal Medicine, Northwestern University, Chicago, Illinois 60611.
J Am Soc Echocardiogr. 1991 Jan-Feb;4(1):19-28. doi: 10.1016/s0894-7317(14)80156-9.
The in vivo acoustic and structural characteristics of atherosclerosis in the descending thoracic aorta have not been well delineated. We prospectively evaluated the descending thoracic aorta of 147 patients (35 women and 112 men; age, 61 +/- 14 years) who underwent clinically indicated transesophageal echocardiography. Patients with suspected disease of the aorta were excluded. Thirty-eight patients (26%) had protruding plaques (men, 25%; women, 29%). Six patients had mobile intimal densities with the mobile area ranging up to 1 cm2. As expected, aortic lumen area was decreased (plaque-free, 3.53 cm2; plaque, 3.19 cm2; p less than 0.05) and wall area was increased (plaque-free, 1.51 cm2; plaque, 1.92 cm2; p less than 0.05) in the regions of the plaque. However, total arterial area was not increased (plaque-free, 5.04 cm2; plaque, 5.09 cm2; difference not significant) in a compensatory manner as observed in other arterial beds. Plaque gray scale was less than the gray scale of plaque-free wall (plaque-free, 141.2; plaque, 122.7; p less than 0.05) when compared at the same level of the descending thoracic aorta or with a second aortic plaque-free level (plaque-free, 150.4; plaque, 122.7; p less than 0.05). Standard deviation of gray scale level was similar between plaque and normal regions. Unsuspected protruding plaques in the descending thoracic aorta occurred in one quarter of the patients referred for routine transesophageal examination. Plaques tended to have lower echogenicity and were differentiated from plaque-free walls within patients. Plaque formation did not result in increased total arterial area. These data suggest that the degree or character of compensatory atherosclerotic remodeling in the highly elastic descending thoracic aorta may differ from other arterial beds.
降主动脉中动脉粥样硬化的体内声学和结构特征尚未得到很好的描述。我们前瞻性地评估了147例接受临床指征经食管超声心动图检查患者（35名女性和112名男性；年龄61±14岁）的降主动脉。排除疑似主动脉疾病的患者。38例患者（26%）有突出斑块（男性25%；女性29%）。6例患者有可移动的内膜密度，可移动区域最大达1 cm²。正如预期的那样，在有斑块的区域，主动脉管腔面积减小（无斑块处为3.53 cm²；有斑块处为3.19 cm²；p<0.05），管壁面积增加（无斑块处为1.51 cm²；有斑块处为1.92 cm²；p<0.05）。然而，总动脉面积并没有像在其他动脉床中观察到的那样以代偿方式增加（无斑块处为5.04 cm²；有斑块处为5.09 cm²；差异无统计学意义）。当在降主动脉同一水平或与降主动脉另一个无斑块水平进行比较时，斑块的灰度低于无斑块管壁的灰度（无斑块处为141.2；有斑块处为122.7；p<0.05）。斑块和正常区域之间灰度水平的标准差相似。在接受常规经食管检查的患者中，四分之一出现了降主动脉中未被怀疑的突出斑块。斑块往往具有较低的回声性，并且在患者体内与无斑块的管壁区分开来。斑块形成并未导致总动脉面积增加。这些数据表明，高度弹性的降主动脉中代偿性动脉粥样硬化重塑的程度或特征可能与其他动脉床不同。
