Kohnken R, Scansen B A, Premanandan C
1 Department of Veterinary Biosciences, College of Veterinary Medicine, The Ohio State University, Columbus, OH, USA.
2 Department of Clinical Sciences, College of Veterinary Medicine, Colorado State University, Fort Collins, CO, USA.
Vet Pathol. 2017 May;54(3):475-483. doi: 10.1177/0300985816685137. Epub 2016 Dec 22.
The vasa vasorum is a delicate network of small arterioles that supplies nutrients to the adventitia and outer media of large arteries. In humans, dysfunction of the vasa vasorum contributes to the pathogenesis of aortic dissection and atherosclerosis. Twenty-four cats from 1 to 18 years of age were prospectively evaluated. Cases were divided into 3 cohorts-with systemic hypertension, without systemic hypertension, and uncertain. Histologic sections of the aorta and main pulmonary artery, as well as sections of kidney and lung, were blindly examined by 2 pathologists. The severity of vasa vasorum arteriopathy was compared to the presence of renal arteriosclerosis, aortic medial degeneration, subintimal fibroplasia of the main pulmonary artery, and blood pressure. We found that vasa vasorum arteriopathy correlated strongly with hypertensive status, degree of renal arteriosclerosis, and lesions in the great vessels. The positive predictive value of a severe vasa vasorum score for systemic hypertension was 84.6%. Lesions of vasa vasorum arteriopathy were predictive of renal arteriosclerosis with 100% sensitivity and 64.7% specificity. The positive predictive value of a severe vasa vasorum score for the presence of aortic lesions was 69.2% vs 91.6% for lesions in the main pulmonary artery. The vasa vasorum appears to be an important responder to systemic hypertension in cats, and arteriopathy of this vascular bed has significant implications for the integrity of the great vessels.
血管滋养管是一个由小动脉组成的精细网络，为大动脉的外膜和中膜外层提供营养。在人类中，血管滋养管功能障碍会导致主动脉夹层和动脉粥样硬化的发病机制。对24只年龄在1至18岁之间的猫进行了前瞻性评估。病例分为3组——患有系统性高血压、不患有系统性高血压以及情况不明。由2名病理学家对主动脉和主肺动脉的组织切片以及肾脏和肺的切片进行盲法检查。将血管滋养管动脉病变的严重程度与肾动脉硬化、主动脉中膜退变、主肺动脉内膜下纤维增生以及血压情况进行比较。我们发现血管滋养管动脉病变与高血压状态、肾动脉硬化程度以及大血管病变密切相关。血管滋养管严重评分对系统性高血压的阳性预测值为84.6%。血管滋养管动脉病变对肾动脉硬化的预测敏感性为100%，特异性为64.7%。血管滋养管严重评分对主动脉病变存在的阳性预测值为69.2%，而对主肺动脉病变的阳性预测值为91.6%。血管滋养管似乎是猫对系统性高血压的重要反应部位，并且这个血管床的动脉病变对大血管的完整性具有重要意义。
