Eindhoven University of Technology, Department of Biomedical Engineering, The Netherlands.
Eur J Vasc Endovasc Surg. 2010 Apr;39(4):410-6. doi: 10.1016/j.ejvs.2009.12.021. Epub 2010 Jan 8.
This study investigated the relation between abdominal aortic aneurysm (AAA) wall stress, AAA growth rate and biomarker concentrations. With increasing wall stress, more damage may be caused to the AAA wall, possibly leading to progression of the aneurysm and reflection in up- or downregulation of specific circulating biomarkers. Levels of matrix metalloproteinase-9, tissue inhibitor of matrix metalloproteinase-1, C-reactive protein and alpha 1-antitrypsin were therefore evaluated.
Thirty-seven patients (maximum AAA diameter 41-55mm) with two, three or four consecutive computed tomography angiography (CTA) scans were prospectively included. Diameter growth rate in mm/year was determined between each pair of two sequential CTA scans. AAA wall stress was computed by finite element analysis, based on the first of the two sequential CTA scans only (n=69 pairs). Biomarker information was determined in 46 measurements in 18 patients. The relation between AAA diameter and wall stress was determined and the AAA's were divided into three equally sized groups (relative low, medium and high stress). Growth rate and biomarker concentrations were compared between these groups. Additionally, correlation coefficients were computed between absolute wall stress, AAA growth and biomarker concentrations.
A relative low AAA wall stress was associated with a lower aneurysm growth rate. Growth rate was also positively related to MMP-9 plasma concentration (r=0.32). The average MMP-9 and CRP concentrations increased with increasing degrees of relative wall stress, although the absolute and relative wall stress did not correlate with any of the biomarkers.
Although lower relative wall stress was associated to a lower AAA growth rate, no relation was found between biomarker concentrations and wall stress. Future research may focus on more and extensive biomarker measurements in relation to AAA wall stress.
本研究旨在探讨腹主动脉瘤（AAA）壁应力、AAA 增长率与生物标志物浓度之间的关系。随着壁应力的增加，AAA 壁可能会受到更大的损伤，从而导致动脉瘤的进展，并反映在特定循环生物标志物的上调或下调上。因此，评估了基质金属蛋白酶-9（MMP-9）、基质金属蛋白酶组织抑制剂-1（TIMP-1）、C 反应蛋白（CRP）和α1-抗胰蛋白酶的水平。
前瞻性纳入 37 名患者（最大 AAA 直径为 41-55mm），这些患者有两次、三次或四次连续的 CT 血管造影（CTA）扫描。在两次连续的 CTA 扫描之间，每对扫描测量 AAA 直径的增长率。仅根据前两次连续 CTA 扫描中的一次计算 AAA 壁应力（n=69 对）。在 18 名患者的 46 次测量中确定了生物标志物信息。确定了 AAA 直径与壁应力之间的关系，并将 AAA 分为三个大小相等的组（相对低、中、高应力）。比较了这些组之间的增长率和生物标志物浓度。此外，还计算了绝对壁应力、AAA 生长和生物标志物浓度之间的相关系数。
相对较低的 AAA 壁应力与较低的动脉瘤生长率相关。生长率与 MMP-9 血浆浓度呈正相关（r=0.32）。尽管绝对和相对壁应力与任何一种生物标志物均无相关性，但 MMP-9 和 CRP 的平均浓度随着相对壁应力的增加而增加。
尽管相对较低的壁应力与较低的 AAA 生长率相关，但生物标志物浓度与壁应力之间未发现关系。未来的研究可能集中在与 AAA 壁应力相关的更多和更广泛的生物标志物测量上。
