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对无气流受限的戒烟者颈动脉血管壁和斑块厚度进行三维超声测量及其与肺部异常的关系。

Three-dimensional ultrasound measurements of carotid vessel wall and plaque thickness and their relationship with pulmonary abnormalities in ex-smokers without airflow limitation.

作者信息

Cheng Jieyu, Pike Damien, Chow Tommy W S, Kirby Miranda, Parraga Grace, Chiu Bernard

机构信息

Department of Electronic Engineering, City University of Hong Kong, 83 Tat Chee Avenue, Kowloon, Hong Kong.

Imaging Research Laboratories, Robarts Research Institute, London, ON, Canada.

出版信息

Int J Cardiovasc Imaging. 2016 Sep;32(9):1391-1402. doi: 10.1007/s10554-016-0931-z. Epub 2016 Jun 24.

Abstract

The relationship between carotid disease and modestly abnormal airflow in ex-smokers without chronic obstructive pulmonary disease (COPD) is not well-understood. We generated 3D ultrasound measurements of carotid vessel-wall-plus-plaque thickness (VWT) and vessel wall volume (VWV) to quantify and evaluate such carotid ultrasound measurements in ex- and never-smokers without airflow limitation. These patients did not fulfill the diagnostic criteria for COPD. We also investigated the relationship of carotid atherosclerosis with pulmonary phenotypes of COPD. We evaluated 61 subjects without a clinical diagnosis of pulmonary or vascular diseases including 34 never-smokers (72 ± 6 year) and 27 ex-smokers (73 ± 9 year). We measured mean VWT ([Formula: see text]) and mean VWT specific to carotid regions-of-interest ([Formula: see text]) and evaluated potential differences between ex- and never-smokers. Carotid ultrasound and pulmonary disease measurement relationships were also evaluated using correlation coefficients (r) and multivariate regression analyses. Ex-smokers had a significantly greater [Formula: see text] (p = 0.003) and [Formula: see text] (p < 0.00001) than never-smokers, whereas a significant difference between the two groups was not detected by VWV (p = 1.0). There were significant correlations between the ventilation defect percent (VDP) measured by MRI with [Formula: see text] (r = 0.42, p = 0.001) and [Formula: see text] (r = 0.56, p = 0.00001). Multivariate regression models showed that VDP significantly predicted [Formula: see text] (β = 0.38, p = 0.004) and [Formula: see text] (β = 0.50, p = 0.00001). VWT-based measurements detected differences in vessel-wall-plus-plaque burden in ex- and never-smokers, which were not revealed using VWV. There were significant correlations between cardiovascular and pulmonary disease biomarkers in these ex-smokers who did not have a clinical diagnosis of pulmonary or carotid disease.

摘要

在无慢性阻塞性肺疾病(COPD)的既往吸烟者中,颈动脉疾病与气流轻度异常之间的关系尚未完全明确。我们通过三维超声测量颈动脉血管壁加斑块厚度(VWT)和血管壁体积(VWV),以量化和评估无气流受限的既往吸烟者和从不吸烟者的颈动脉超声测量结果。这些患者不符合COPD的诊断标准。我们还研究了颈动脉粥样硬化与COPD肺部表型之间的关系。我们评估了61名无肺部或血管疾病临床诊断的受试者,其中包括34名从不吸烟者(72±6岁)和27名既往吸烟者(73±9岁)。我们测量了平均VWT([公式:见正文])和特定于颈动脉感兴趣区域的平均VWT([公式:见正文]),并评估了既往吸烟者和从不吸烟者之间的潜在差异。还使用相关系数(r)和多元回归分析评估了颈动脉超声与肺部疾病测量结果之间的关系。既往吸烟者的[公式:见正文](p = 0.003)和[公式:见正文](p < 0.00001)显著高于从不吸烟者,而两组之间在VWV方面未检测到显著差异(p = 1.0)。通过MRI测量的通气缺陷百分比(VDP)与[公式:见正文](r = 0.42,p = 0.001)和[公式:见正文](r = 0.56,p = 0.00001)之间存在显著相关性。多元回归模型显示,VDP显著预测了[公式:见正文](β = 0.38,p = 0.004)和[公式:见正文](β = 0.50,p = 0.00001)。基于VWT的测量方法检测到了既往吸烟者和从不吸烟者在血管壁加斑块负荷方面的差异,而使用VWV未发现这些差异。在这些无肺部或颈动脉疾病临床诊断的既往吸烟者中,心血管和肺部疾病生物标志物之间存在显著相关性。

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