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评估肥胖和血脂异常门诊就诊青少年弹性和肌肉动脉壁形态的超高分辨率超声的可行性。

Feasibility of very-high resolution ultrasound to assess elastic and muscular arterial wall morphology in adolescents attending an outpatient clinic for obesity and lipid abnormalities.

机构信息

Division of Cardiology, Labatt Family Heart Centre, The Hospital for Sick Children, University of Toronto, Toronto, Canada.

出版信息

Atherosclerosis. 2011 Dec;219(2):610-5. doi: 10.1016/j.atherosclerosis.2011.08.036. Epub 2011 Aug 27.

Abstract

OBJECTIVE

Atherosclerosis begins during early life and is accelerated in individuals with cardiovascular risk factors. We hypothesized that very-high resolution ultrasound (VHRU, 25-55 MHz) could feasibly detect early arterial changes in adolescents with risk factors.

METHODS

We prospectively imaged the carotid, brachial and radial arterial morphology (far wall intima-media thickness, IMT; adventitia thickness, AT) by VHRU in 58 youths (age 14 ± 2 years) attending a Pediatric Preventive Cardiology Clinic for assessment and management of cardiovascular risk factors and compared the findings to those from an age-matched group of 67 controls.

RESULTS

Brachial and radial imaging was successful for all subjects. The carotid far wall could not be imaged in 7% of the patients due to limitations in penetration. VHRU image quality was related to body size and imaging depth. Imaging and analysis time were 12 ± 3 and 18 ± 3 min, respectively. Carotid IMT was increased in patients (0.42 ± 0.05 vs. 0.40 ± 0.06 mm, p = 0.05). No differences were found in brachial or radial IMT or AT vs. controls. Age, male gender, body mass index, systolic blood pressure (BP), but not lipid levels, were associated with arterial IMT in regression analyses.

CONCLUSION

VHRU is feasible in imaging carotid and peripheral muscular artery IMT in adolescents. The arterial IMT is associated with age, gender, adiposity and systolic BP, but not lipid levels, in this adolescent population. Further studies including patients with manifest clinical atherosclerosis are needed to assess if VHRU has applications in atherosclerosis research.

摘要

目的

动脉粥样硬化始于生命早期,并在心血管危险因素个体中加速发展。我们假设,超高分辨率超声(VHRU,25-55MHz)可在具有危险因素的青少年中检测到早期动脉变化。

方法

我们前瞻性地通过 VHRU 对 58 名(年龄 14±2 岁)在儿科预防心脏病学诊所就诊以评估和管理心血管危险因素的青少年的颈动脉、肱动脉和桡动脉形态(远壁内膜-中层厚度(IMT);外膜厚度(AT))进行成像,并将结果与年龄匹配的 67 名对照组进行比较。

结果

所有受试者均成功进行了肱动脉和桡动脉成像。由于穿透受限,7%的患者无法对颈动脉远壁进行成像。VHRU 图像质量与体型和成像深度有关。成像和分析时间分别为 12±3 和 18±3 分钟。与对照组相比,患者的颈动脉 IMT 增加(0.42±0.05 比 0.40±0.06mm,p=0.05)。肱动脉或桡动脉的 IMT 或 AT 与对照组无差异。回归分析显示,年龄、男性、体重指数、收缩压(BP),而不是血脂水平,与动脉 IMT 相关。

结论

VHRU 可用于对青少年的颈动脉和外周肌肉动脉 IMT 进行成像。在该青少年人群中,动脉 IMT 与年龄、性别、肥胖和收缩压相关,而与血脂水平无关。需要进一步包括有明显临床动脉粥样硬化的患者的研究,以评估 VHRU 在动脉粥样硬化研究中的应用。

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