Arcidiacono Maria Vittoria, Rubinat Esther, Borras Mercè, Betriu Angels, Trujillano Javier, Vidal Teresa, Mauricio Didac, Fernández Elvira
Department of Nephrology, Hospital Universitari Arnau de Vilanova, Avda Rovira Roure, 80, 25198, Lleida, Spain.
Unitat de Detecció i Tractament de Malalties Aterotrombòtiques, Hospital Universitari Arnau de Vilanova, Avda Rovira Roure, 80, 25198, Lleida, Spain.
Cardiovasc Ultrasound. 2015 Apr 17;13:20. doi: 10.1186/s12947-015-0014-7.
The early identification of the onset of subclinical atheromatosis is essential in reducing the high mortality risk from cardiovascular disease (CVD) worldwide. Although carotid intima-media thickness (cIMT) is the most commonly used early predictor of ongoing atherosclerosis, an experimental model of atherosclerosis, demonstrated that increases in adventitial microvessels (vasa vasorum (VV)) precede endothelial dysfunction. Using the reported accuracy of contrast-enhanced ultrasound (CEU) to measure carotid adventitial VV, this study assessed whether measurements of carotid adventitial VV serve as a marker of subclinical atherosclerotic lesions in a control population with none of the classical risk factors for CVD.
Measurements of cIMT (B-mode ultrasound) and adventitial VV (CEU) were conducted in 65 subjects, 30-70 years old, 48% men, with none of the classical risk factors for CVD. Adventitial VV strongly correlated with its own cIMT only in the left carotid artery. Importantly, the left carotid adventitial VV directly correlated with age.
The increases with age in left carotid adventitial VV in individuals with zero risk for atheromatosis suggest that the measurement of carotid adventitial VV could be an accurate and sensitive marker for the diagnosis of subclinical atheromatosis and therefore a prominent tool for monitoring the efficacy of anti-atheromatous therapies.
早期识别亚临床动脉粥样硬化的发病对于降低全球心血管疾病(CVD)的高死亡风险至关重要。尽管颈动脉内膜中层厚度(cIMT)是目前最常用的动脉粥样硬化进展早期预测指标,但一项动脉粥样硬化实验模型表明,外膜微血管(滋养血管(VV))增加先于内皮功能障碍出现。本研究利用已报道的对比增强超声(CEU)测量颈动脉外膜VV的准确性,评估在无CVD经典危险因素的对照人群中,颈动脉外膜VV测量值是否可作为亚临床动脉粥样硬化病变的标志物。
对65名年龄在30至70岁之间、男性占48%且无CVD经典危险因素的受试者进行了cIMT(B型超声)和外膜VV(CEU)测量。仅在左侧颈动脉中,外膜VV与其自身的cIMT密切相关。重要的是,左侧颈动脉外膜VV与年龄直接相关。
在无动脉粥样硬化风险个体中,左侧颈动脉外膜VV随年龄增加,这表明颈动脉外膜VV测量可能是诊断亚临床动脉粥样硬化的准确且敏感的标志物,因此也是监测抗动脉粥样硬化治疗疗效的重要工具。