Papageorgiou G L, Jones B N, Redding V J, Hudson N
Department of Engineering, University of Leicester, United Kingdom.
Cardiovasc Res. 1990 Jun;24(6):478-84. doi: 10.1093/cvr/24.6.478.
The aim of the study was to establish measurements for the area ratios of normal arterial junctions at various anatomical sites in order to estimate the significance of pulse wave reflections in the healthy arterial system.
Coronary cineangiograms were used for the coronary junctions measurements and routine arteriograms for the rest of the junctions studied. A pair of digital calipers served to take measurements at a distance of one vessel diameter from the junction centre.
A bell shaped distribution of arterial area ratios was found with mean value for coronary bifurcations of 1.179 (95% confidence limits, 1.138-1.220). Slightly higher values were found for the higher order coronary junctions. Other junctions had similar area ratio values with the exception of the aortoiliac junctions where the area ratio was found 0.848 (0.775-0.920). Overall area ratio was 1.14 (1.113-1.167). Asymmetrical coronary bifurcations had higher area ratio than symmetrical ones (p less than 0.05).
In the majority of cases the area ratios are in close agreement with the theoretically predicted values for forward matched junctions. Minimal pulse wave reflections are therefore expected to arise from the junctions of a healthy arterial system. We therefore consider that, contrary to the established view, the presence of reflected waves in the central arterial system is a potential pathological phenomenon and not a characteristic of the healthy system. This may have important theoretical implications for the way hemodynamic findings are interpreted. Finally we suggest that arterial area ratio can be considered as another criterion of normality of arterial junctions in the interpretation of angiograms.
本研究旨在确定不同解剖部位正常动脉交界处的面积比测量值，以评估健康动脉系统中脉搏波反射的意义。
冠状动脉造影用于测量冠状动脉交界处，其余研究的交界处则使用常规动脉造影。用一对数字卡尺在距交界处中心一个血管直径的距离处进行测量。
发现动脉面积比呈钟形分布，冠状动脉分叉处的平均值为1.179（95%置信区间，1.138 - 1.220）。高阶冠状动脉交界处的值略高。其他交界处的面积比值相似，但主动脉髂动脉交界处除外，其面积比为0.848（0.775 - 0.920）。总体面积比为1.14（1.113 - 1.167）。不对称冠状动脉分叉处的面积比高于对称分叉处（p < 0.05）。
在大多数情况下，面积比与正向匹配交界处的理论预测值密切一致。因此，预计健康动脉系统的交界处产生的脉搏波反射极小。我们因此认为，与既定观点相反，中心动脉系统中反射波的存在是一种潜在的病理现象，而非健康系统的特征。这可能对血流动力学结果的解释方式具有重要的理论意义。最后，我们建议在血管造影解释中，动脉面积比可被视为动脉交界处正常与否的另一个标准。
