Templeton Danielle L, John Ranjit, Painter Patricia, Kelly Aaron S, Dengel Donald R
School of Kinesiology, University of Minnesota, Minneapolis, USA.
Heart Vessels. 2013 May;28(3):377-84. doi: 10.1007/s00380-012-0271-4. Epub 2012 Aug 9.
We investigated the impact of continuous-flow left ventricular assist devices (LVAD) on the carotid elastic properties. Carotid artery parameters (diameter distensibility (DD), cross-sectional distensibility (CSD), diameter compliance (DC), cross-sectional compliance (CSC), and incremental elastic modulus (IEM)) were measured in a cross-sectional study using a standard ultrasound with a 10-MHz linear array probe. Measurements (mean ± SEM) were made in separate groups at various clinical time points: prior to LVAD surgery (baseline; 13 male/3 female; age 48 ± 3 years), 1 week following LVAD placement (acute; 12 male/2 female; age 47 ± 3 years), approximately 24 weeks following LVAD surgery (chronic; 13 male/2 female; age 52 ± 3 years), and in a group of healthy subjects (controls; 9 male/1 female; age 51 ± 4 years). Distensibility properties were lower (P < 0.05) in the acute (DD 2.3 % ± 0.4 %; CSD 4.7 % ± 0.8 %) and chronic (DD 2.2 % ± 0.4 %; CSD 4.5 ± 0.9 %) compared with the baseline (DD 5.9 % ± 0.7 %; CSD 12.2 % ± 1.5 %) and control (DD 5.8 % ± 0.6 %; CSD 11.9 % ± 1.3 %) groups. Compliance properties were lower (P < 0.05) in the chronic (DC 4.4 ± 0.7 mm/mmHg × 10(-3); CSC 1.2 ± 0.2 mmHg(-1) × 10(-3)) compared with acute (DC 9.0 ± 1.6 mm/mmHg × 10(-3); CSC 2.6 ± 0.4 mmHg(-1) × 10(-3)) and baseline (DC 11.1 ± 1.1 mm/mmHg × 10(-3); CSC 3.3 ± 0.4 mmHg(-1) × 10(-3)) groups. The compliance properties in the control (DC 8.3 ± 0.8 mm/mmHg × 10(-3); CSC 2.4 ± 0.2 mmHg(-1) × 10(-3)) group were not different from any of the patient groups. The IEM was higher (P < 0.05) in the chronic (6908 ± 1269 mmHg) compared with acute (2739 ± 412 mmHg), baseline (1849 ± 177 mmHg), and control (2349 ± 241 mmHg) groups. Chronic continuous-flow LVAD support is associated with lower carotid artery compliance and distensibility, which may place further strain on the left ventricle.
我们研究了连续血流左心室辅助装置（LVAD）对颈动脉弹性特性的影响。在一项横断面研究中，使用配备10MHz线性阵列探头的标准超声测量颈动脉参数（直径扩张性（DD）、横截面积扩张性（CSD）、直径顺应性（DC）、横截面积顺应性（CSC）和增量弹性模量（IEM））。在不同临床时间点对不同组进行测量（均值±标准误）：LVAD手术前（基线；13名男性/3名女性；年龄48±3岁）、LVAD植入后1周（急性期；12名男性/2名女性；年龄47±3岁）、LVAD手术后约24周（慢性期；13名男性/2名女性；年龄52±3岁），以及一组健康受试者（对照组；9名男性/1名女性；年龄51±4岁）。与基线组（DD 5.9%±0.7%；CSD 12.2%±1.5%）和对照组（DD 5.8%±0.6%；CSD 11.9%±1.3%）相比，急性期（DD 2.3%±0.4%；CSD 4.7%±0.8%）和慢性期（DD 2.2%±0.4%；CSD 4.5±0.9%）的扩张性特性较低（P<0.05）。与急性期（DC 9.0±1.6 mm/mmHg×10⁻³；CSC 2.6±0.4 mmHg⁻¹×10⁻³）和基线组（DC 11.1±1.1 mm/mmHg×10⁻³；CSC 3.3±0.4 mmHg⁻¹×10⁻³）相比，慢性期（DC 4.4±0.7 mm/mmHg×10⁻³；CSC 1.2±0.2 mmHg⁻¹×10⁻³）的顺应性特性较低（P<0.05）。对照组（DC 8.3±0.8 mm/mmHg×10⁻³；CSC 2.4±0.2 mmHg⁻¹×10⁻³）的顺应性特性与任何患者组均无差异。与急性期（2739±412 mmHg）、基线组（18889±177 mmHg）和对照组（2349±241 mmHg）相比，慢性期（6908±1269 mmHg）的IEM较高（P<0.05）。慢性连续血流LVAD支持与较低的颈动脉顺应性和扩张性相关，这可能会给左心室带来进一步的压力。
