Novo G, Di Miceli R, Novo S
Division of Cardiology, Center for the Early Diagnosis of Preclinical and Multifocal Atherosclerosis, University Hospital "Paolo Giaccone", Palermo, Italy -
Int Angiol. 2013 Dec;32(6):575-80.
The aim of our study was to explore the changes in common carotid arterial intima-media thickness (CCA IMT) and local arterial stiffness to evaluate, non-invasively, early vascular disease in patients with cardiovascular (CV) risk factors and "normal" carotid IMT (<0.9 mm).
We studied 50 patients (mean age 42 years±14), with no history of cardio-cerebrovascular events and "normal" IMT. We assessed the traditional cardiovascular risk factors, the CCA IMT, and the local stiffness with Quality Arterial Stiffness technology, based on Radio frequency signal (RFQAS-ESAOTE, Italy). CCA distensibility coefficient (DC), compliance coefficient (CC), pulse wave velocity (PWV) and β parameter were measured in patients, with and without traditional cardiovascular risk factors. 25 subjects with risk factors (mean age 49±13) were compared with 25 controls (mean age 36±12).
We did not find any significant differences in the IMT measurement between subjects with CV risk factors compared to controls (0.530±0.99 mm vs. 0.626±0.127 mm; P=5.68). The mean DC (0.030±0.014 1/kPa vs. 0.0221±0.016 1/kPa; P<0.05) and CC (1.087±0.47 mm²/kPA vs. 0.864±0.41 mm²/kPA; P<0.05), were significantly lower, while PWV (6.21±1.74 m/s vs. 7.68±2.07 m/s; P<0.05) and β (7.67±4.09 m/s vs. 10.45±5.58 m/s; P<0.05) were significantly higher in subjects with CV risk factors. ROC curves showed that PWV>6.05 m/s better identified, among patients with IMT <0.9 mm, those with cardiovascular risk factors (sensitivity 82.0% specificity 62.0%; AUC 0.73).
Increased stiffness is a result of change both in quantity and quality of the arterial wall. Arterial functional changes and distention alterations may herald the onset of vascular disease before manifestation of symptoms or detection of preclinical atherosclerotic lesions.
本研究旨在探讨颈总动脉内膜中层厚度（CCA IMT）和局部动脉僵硬度的变化，以无创评估具有心血管（CV）危险因素且颈动脉IMT“正常”（<0.9 mm）患者的早期血管疾病。
我们研究了50例患者（平均年龄42岁±14岁），他们无心血管脑血管事件病史且IMT“正常”。我们评估了传统心血管危险因素、CCA IMT，并使用基于射频信号的质量动脉僵硬度技术（RFQAS - ESAOTE，意大利）测量局部僵硬度。在有和没有传统心血管危险因素的患者中测量CCA扩张系数（DC）、顺应性系数（CC）、脉搏波速度（PWV）和β参数。将25例有危险因素的受试者（平均年龄49±13岁）与25例对照组（平均年龄36±12岁）进行比较。
我们发现有CV危险因素的受试者与对照组之间在IMT测量上没有显著差异（0.530±0.99 mm对0.626±0.127 mm；P = 5.68）。有CV危险因素的受试者的平均DC（0.030±0.014 1/kPa对0.0221±0.016 1/kPa；P<0.05）和CC（1.087±0.47 mm²/kPA对0.864±0.41 mm²/kPA；P<0.05）显著更低，而PWV（6.21±1.74 m/s对7.68±2.07 m/s；P<0.05）和β（7.67±4.09 m/s对10.45±5.58 m/s；P<0.05）显著更高。ROC曲线显示，在IMT<0.9 mm的患者中，PWV>6.05 m/s能更好地识别出有心血管危险因素的患者（敏感性82.0%，特异性62.0%；AUC 0.73）。
僵硬度增加是动脉壁数量和质量变化的结果。动脉功能变化和扩张改变可能在症状出现或临床前期动脉粥样硬化病变检测之前预示血管疾病的发生。
