Abbas Abeera, Cecelja Marina, Hussain Tarique, Greil Gerald, Modarai Bijan, Waltham Matthew, Chowienczyk Philip J, Smith Alberto
aAcademic Department of Vascular Surgery bClinical Pharmacology Department cDivision of Imaging Sciences, King's College London, London, UK *Joint first authors. †Joint senior investigators.
J Hypertens. 2015 May;33(5):1032-8. doi: 10.1097/HJH.0000000000000516.
Increased stiffening of the aortic wall could contribute to the development of abdominal aortic aneurysm (AAA). We investigated regional aortic wall pulse wave velocity (PWV) in patients with AAA.
Forty-six men diagnosed with a small AAA and 42 control men were recruited from the AAA surveillance and screening programmes at Guy's and St Thomas' Hospital. Phase-contrast cardiovascular MRI was performed to determine regional PWV along the thoracic (PWVTHOR) and abdominal aorta (PWVABD). PWV over the total aorta (PWVTOTAL) was calculated from the combined regions.
PWVTOTAL was significantly higher in patients with AAA compared to controls (10.0 ± 2.1 versus 8.4 ± 1.6 m/s, respectively; P < 0.0001). The difference in total aortic PWV between groups was explained by increased thoracic PWV in patients with AAA compared to controls (PWVTHOR 9.9 ± 2.8 versus 8.1 ± 2.5 m/s, respectively; P < 0.01). In contrast, there was no difference in PWV measured over the abdominal region in AAA patients compared with controls (PWVABD 10.7 ± 3.3 and 10.1 ± 3.3 m/s, in AAA and control groups, respectively; P = 0.40). In multiple regression analysis, including the whole cohort, abdominal aortic diameter remained significantly associated with PWVTOTAL and PWVTHOR (standardized regression coefficients 0.22 and 0.19, respectively; each P < 0.05 after adjustment for age and mean arterial pressure), but not with PWVABD.
AAA patients have a greater PWV in the thoracic but not abdominal aorta compared to control individuals. Greater abdominal aortic diameter in patients with AAA is likely to offset effects of intrinsic stiffening of the abdominal aorta on PWV.
主动脉壁僵硬度增加可能促使腹主动脉瘤（AAA）的发生。我们对AAA患者的主动脉壁区域脉搏波速度（PWV）进行了研究。
从盖伊和圣托马斯医院的AAA监测与筛查项目中招募了46名被诊断为小AAA的男性和42名对照男性。采用相位对比心血管磁共振成像来测定沿胸主动脉（PWVTHOR）和腹主动脉（PWVABD）的区域PWV。根据合并区域计算整个主动脉的PWV（PWVTOTAL）。
与对照组相比，AAA患者的PWVTOTAL显著更高（分别为10.0±2.1与8.4±1.6 m/s；P<0.0001）。两组间主动脉总PWV的差异是由于与对照组相比，AAA患者的胸主动脉PWV增加（PWVTHOR分别为9.9±2.8与8.1±2.5 m/s；P<0.01）。相比之下，AAA患者与对照组在腹部区域测量的PWV无差异（AAA组和对照组的PWVABD分别为10.7±3.3和10.1±3.3 m/s；P=0.40）。在包括整个队列的多元回归分析中，腹主动脉直径仍与PWVTOTAL和PWVTHOR显著相关（标准化回归系数分别为0.22和0.19；在调整年龄和平均动脉压后，各P<0.05），但与PWVABD无关。
与对照个体相比，AAA患者胸主动脉的PWV更高，但腹主动脉并非如此。AAA患者较大的腹主动脉直径可能抵消腹主动脉固有僵硬度对PWV的影响。
