Elbasan Zafer, Sahin Durmuş Yıldıray, Gür Mustafa, Kalkan Gülhan Yüksel, Yıldız Ali, Kaya Zekeriya, Kıvrak Ali, Gözübüyük Gökhan, Özdoğru Ibrahim, Çaylı Murat
Department of Cardiology, Adana Numune Education and Research Hospital, Adana, Turkey.
Echocardiography. 2013 Apr;30(4):407-13. doi: 10.1111/echo.12066. Epub 2012 Dec 10.
There is growing evidence that aortic distensibility (AD) is a subclinical marker of early atherosclerosis. Aortic intima-media thickness (IMT) was an earlier marker than carotid IMT of preclinical atherosclerosis. In this study, we aimed to assess the relationship between thoracic aortic IMT and AD.
We studied 192 patients (mean age: 45.5 ± 8.4 years) who underwent transesophageal echocardiography (TEE) for various indications. Four different grades were determined according to IMT of thoracic aorta (Grade 1 < 1 mm; 1 mm ≤ Grade 2 < 3 mm; 3 mm ≤ Grade 3 < 5 mm; 5 mm ≤ Grade 4). AD was calculated from the echocardiographically derived ascending aorta diameters and hemodynamic pressure measurements in all patients. High sensitive C-reactive protein (hsCRP) and other biochemical markers were measured using an automated chemistry analyzer.
TEE evaluation characterized thoracic aortic intimal morphology as grade 1 in 71 patients (37%), grade 2 in 57 patients (29.7%), grade 3 in 34 patients (17.7%), and grade 4 in 30 (15.6%) patients. The lowest AD level was observed in grade 4 group compared with grade 1 and grade 2 groups (P < 0.001, P = 0.009, respectively). AD level of grade 3 group was lower than grade 1 and grade 2 group (P < 0.001, P = 0.021, respectively). In multiple linear regression analysis, AD was independently associated with age (β = -0.138, P = 0.029), hsCRP (β = -0.209, P = 0.001), and aortic IMT (β = -0.432, P < 0.001).
AD is independently associated with age, thoracic aortic IMT, and hsCRP. Impaired elasticity index of the aorta might be an independent predictor for the severity of thoracic atherosclerosis.
越来越多的证据表明，主动脉扩张性（AD）是早期动脉粥样硬化的亚临床标志物。主动脉内膜中层厚度（IMT）是临床前期动脉粥样硬化比颈动脉IMT更早出现的标志物。在本研究中，我们旨在评估胸主动脉IMT与AD之间的关系。
我们研究了192例因各种适应证接受经食管超声心动图（TEE）检查的患者（平均年龄：45.5±8.4岁）。根据胸主动脉IMT确定了四个不同等级（1级<1mm；1mm≤2级<3mm；3mm≤3级<5mm；5mm≤4级）。所有患者均根据超声心动图得出的升主动脉直径和血流动力学压力测量值计算AD。使用自动化学分析仪测量高敏C反应蛋白（hsCRP）和其他生化标志物。
TEE评估显示，71例患者（37%）的胸主动脉内膜形态为1级，57例患者（29.7%）为2级，34例患者（17.7%）为3级，30例患者（15.6%）为4级。与1级和2级组相比，4级组的AD水平最低（分别为P<0.001，P=0.009）。3级组的AD水平低于1级和2级组（分别为P<0.001，P=0.021）。在多元线性回归分析中，AD与年龄（β=-0.138，P=0.029）、hsCRP（β=-0.209，P=0.001）和主动脉IMT（β=-0.432，P<0.001）独立相关。
AD与年龄、胸主动脉IMT和hsCRP独立相关。主动脉弹性指数受损可能是胸段动脉粥样硬化严重程度的独立预测指标。
