颈总动脉内膜中层厚度和踝臂压力指数与局部而非整体动脉粥样硬化负荷相关：一项使用全身磁共振血管造影的横断面研究。
Common carotid intima media thickness and ankle-brachial pressure index correlate with local but not global atheroma burden: a cross sectional study using whole body magnetic resonance angiography.
作者信息
Weir-McCall Jonathan R, Khan Faisel, Lambert Matthew A, Adamson Carly L, Gardner Michael, Gandy Stephen J, Ramkumar Prasad Guntur, Belch Jill J F, Struthers Allan D, Rauchhaus Petra, Morris Andrew D, Houston J Graeme
机构信息
Division of Cardiovascular and Diabetes Medicine, Medical Research Institute, University of Dundee, Dundee, United Kingdom; NHS Tayside Clinical Radiology, Ninewells Hospital, Dundee, United Kingdom.
Vascular & Inflammatory Diseases Research Unit, Medical Research Institute, University of Dundee, Dundee, United Kingdom.
出版信息
PLoS One. 2014 Jun 16;9(6):e99190. doi: 10.1371/journal.pone.0099190. eCollection 2014.
BACKGROUND
Common carotid intima media thickness (CIMT) and ankle brachial pressure index (ABPI) are used as surrogate marker of atherosclerosis, and have been shown to correlate with arterial stiffness, however their correlation with global atherosclerotic burden has not been previously assessed. We compare CIMT and ABPI with atheroma burden as measured by whole body magnetic resonance angiography (WB-MRA).
METHODS
50 patients with symptomatic peripheral arterial disease were recruited. CIMT was measured using ultrasound while rest and exercise ABPI were performed. WB-MRA was performed in a 1.5T MRI scanner using 4 volume acquisitions with a divided dose of intravenous gadolinium gadoterate meglumine (Dotarem, Guerbet, FR). The WB-MRA data was divided into 31 anatomical arterial segments with each scored according to degree of luminal narrowing: 0 = normal, 1 = <50%, 2 = 50-70%, 3 = 70-99%, 4 = vessel occlusion. The segment scores were summed and from this a standardized atheroma score was calculated.
RESULTS
The atherosclerotic burden was high with a standardised atheroma score of 39.5±11. Common CIMT showed a positive correlation with the whole body atheroma score (β 0.32, p = 0.045), however this was due to its strong correlation with the neck and thoracic segments (β 0.42 p = 0.01) with no correlation with the rest of the body. ABPI correlated with the whole body atheroma score (β -0.39, p = 0.012), which was due to a strong correlation with the ilio-femoral vessels with no correlation with the thoracic or neck vessels. On multiple linear regression, no correlation between CIMT and global atheroma burden was present (β 0.13 p = 0.45), while the correlation between ABPI and atheroma burden persisted (β -0.45 p = 0.005).
CONCLUSION
ABPI but not CIMT correlates with global atheroma burden as measured by whole body contrast enhanced magnetic resonance angiography in a population with symptomatic peripheral arterial disease. However this is primarily due to a strong correlation with ilio-femoral atheroma burden.
背景
颈总动脉内膜中层厚度（CIMT）和踝臂指数（ABPI）被用作动脉粥样硬化的替代标志物，且已被证明与动脉僵硬度相关，然而它们与整体动脉粥样硬化负担的相关性此前尚未得到评估。我们将CIMT和ABPI与通过全身磁共振血管造影（WB-MRA）测量的动脉粥样硬化斑块负担进行比较。
方法
招募了50例有症状的外周动脉疾病患者。使用超声测量CIMT，同时测量静息和运动时的ABPI。在1.5T MRI扫描仪中进行WB-MRA，采用4次容积采集，并静脉注射钆喷酸葡胺（Dotarem，Guerbet，法国）的分剂量造影剂。将WB-MRA数据分为31个解剖动脉节段，每个节段根据管腔狭窄程度进行评分：0 = 正常，1 = <50%，2 = 50 - 70%，3 = 70 - 99%，4 = 血管闭塞。将节段评分相加，并据此计算标准化的动脉粥样硬化斑块评分。
结果
动脉粥样硬化负担较高，标准化动脉粥样硬化斑块评分为39.5±11。颈总动脉内膜中层厚度与全身动脉粥样硬化斑块评分呈正相关（β 0.32，p = 0.045），然而这是由于其与颈部和胸部节段的强相关性（β 0.42，p = 0.01），与身体其他部位无相关性。ABPI与全身动脉粥样硬化斑块评分相关（β -0.39，p = 0.012），这是由于与髂股血管的强相关性，与胸部或颈部血管无相关性。在多元线性回归分析中，CIMT与整体动脉粥样硬化负担之间无相关性（β 0.13，p = 0.45），而ABPI与动脉粥样硬化负担之间的相关性仍然存在（β -0.45，p = 0.005）。
结论
在有症状的外周动脉疾病人群中，ABPI而非CIMT与通过全身对比增强磁共振血管造影测量的整体动脉粥样硬化负担相关。然而，这主要是由于与髂股动脉粥样硬化负担的强相关性。
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