Akcay M, Akcay E, Yeter E, Durmaz T, Keles T, Bayram N A, Yuksel I, Yuksel Kalkan G, Ayhan H, Simavli H, Simsek S, Bozkurt E
Ankara Ataturk Education and Research Hospital, Department of Cardiology, Ankara, Turkey.
Vasa. 2011 Jan;40(1):41-8. doi: 10.1024/0301-1526/a000068.
Aortic elastic properties have been shown to be an important predictor of cardiovascular morbidity and mortality. Hyperthyroidism was shown to be an important cause of impaired aortic elastic properties both due to the direct effect of the thyroid hormones on the aorta and also due to modulating effects of thyroid hormones on the vascular renin angiotensin system. However, there is no study investigating the aortic elastic properties in Graves's patients who were euthyroid. The goal of the present study was to investigate the aortic elastic properties of patients with Graves' Ophtalmopathy (GO) who had been euthyroid for at least 3 months.
A cross-sectional study was performed on 47 GO patients and 27 controls. Aortic-diastolic and aortic-systolic diameters, aortic strain, aortic distensibility, and aortic stiffness indices were calculated from the diameter of the thoracic aorta as measured by transthoracic echocardiography.
The aortic stiffness index was markedly increased (31 ± 26 vs. 17 ± 8.9; p = 0.015) and aortic strain was markedly reduced (20.3 ± 10 % vs. 25.9 ± 12 %; p = 0.046) in the GO group relative to the control group. Aortic distensibility was statistically significantly decreased in the GO group as compared to the control group (9.5 ± 5.7 10(-3)/kPa vs. 13.5 ± 7.1 10(-3)/kPa; p = 0.022). Weak correlations were detected between GO severity and aortic distensibility (r = -0.333, p = 0.011) as well as the aortic stiffness index (r = 0.266, p = 0.044).
Aortic elastic properties were impaired in patients with GO. Therefore, patients with GO, especially those with severe manifestations of the condition, should be followed closely with regard to the occurrence of future cardiovascular events.
主动脉弹性特性已被证明是心血管疾病发病率和死亡率的重要预测指标。甲状腺功能亢进症被证明是主动脉弹性特性受损的重要原因，这既归因于甲状腺激素对主动脉的直接作用，也归因于甲状腺激素对血管肾素 - 血管紧张素系统的调节作用。然而，尚无研究调查甲状腺功能正常的格雷夫斯病患者的主动脉弹性特性。本研究的目的是调查甲状腺功能正常至少3个月的格雷夫斯眼病（GO）患者的主动脉弹性特性。
对47例GO患者和27例对照进行了横断面研究。通过经胸超声心动图测量胸主动脉直径，计算主动脉舒张期和收缩期直径、主动脉应变、主动脉扩张性和主动脉僵硬度指数。
与对照组相比，GO组的主动脉僵硬度指数显著升高（31±26 vs. 17±8.9；p = 0.015），主动脉应变显著降低（20.3±10% vs. 25.9±12%；p = 0.046）。与对照组相比，GO组的主动脉扩张性在统计学上显著降低（9.5±5.7×10⁻³/kPa vs. 13.5±7.1×10⁻³/kPa；p = 0.022）。检测到GO严重程度与主动脉扩张性（r = -0.333，p = 0.011）以及主动脉僵硬度指数（r = 0.266，p = 0.044）之间存在弱相关性。
GO患者的主动脉弹性特性受损。因此，对于GO患者，尤其是那些病情严重的患者，应密切关注未来心血管事件的发生。
