Department of Health Science, Magna Graecia University, Catanzaro, Italy.
Division of Cardiology, Department of Medical and Surgical Science, Magna Graecia University, Catanzaro, Italy.
J Investig Med. 2018 Jun;66(5):1-7. doi: 10.1136/jim-2017-000644. Epub 2018 Mar 17.
Endothelial dysfunction, wall thickening and plaque are progressive manifestations of atherosclerosis. Delayed or absent brachial artery dilation after ischemic stimulus has been associated with severity of extracoronary and coronary atherosclerosis. In the current study, we aimed to verify if delayed or absent dilation associates with critical coronary stenosis. We also evaluated the association between coronary stenosis, carotid artery wall thickness and peripheral artery disease. Endothelial function was investigated by flow-mediated dilation of the brachial artery up to 3 min after ischemia, and patients classified as early, late or no dilators. Coronary angiography was performed through transradial or femoral artery approach. Computerized quantitative angiography was used to obtain percent stenosis of all lesions, while the Gensini score was used to evaluate the severity of coronary atherosclerosis. Seventy-four patients were enrolled. Carotid wall thickness and plaque, and peripheral artery disease were detected by ultrasound. Subjects with critical coronary stenosis showed a higher prevalence of delayed or absent dilation (coronary stenosis ≥70 per cent: late dilators 50 per cent, no dilators 35 per cent; coronary stenosis ≤70 per cent : late dilators 27 per cent, no dilators 6 per cent). The Gensini score was progressively higher in late dilators and no dilators compared with early dilators (early: 4.5±13.5; late 17.5±27.1; no 39.7±55.0; P<0.02). Carotid atherosclerosis and peripheral artery disease were more prevalent in subjects with critical coronary stenosis. Delayed or absent dilation associates with coronary stenosis and different degree of coronary atherosclerosis. The kinetic of arterial dilation seems to be relevant as the magnitude of dilation.
内皮功能障碍、管壁增厚和斑块是动脉粥样硬化的渐进表现。缺血刺激后肱动脉扩张延迟或消失与冠状动脉和冠状动脉外动脉粥样硬化的严重程度有关。在目前的研究中，我们旨在验证扩张延迟或消失是否与临界冠状动脉狭窄有关。我们还评估了冠状动脉狭窄、颈动脉壁厚度和外周动脉疾病之间的相关性。通过缺血后 3 分钟内肱动脉血流介导的扩张来评估内皮功能，将患者分为早期、晚期或无扩张者。通过桡动脉或股动脉途径进行冠状动脉造影。计算机定量血管造影用于获得所有病变的狭窄百分比，而 Gensini 评分用于评估冠状动脉粥样硬化的严重程度。共纳入 74 例患者。通过超声检查检测颈动脉壁厚度和斑块以及外周动脉疾病。临界冠状动脉狭窄患者表现出扩张延迟或消失的更高发生率（冠状动脉狭窄≥70%：晚期扩张者 50%，无扩张者 35%；冠状动脉狭窄≤70%：晚期扩张者 27%，无扩张者 6%）。与早期扩张者相比，晚期扩张者和无扩张者的 Gensini 评分逐渐升高（早期：4.5±13.5；晚期 17.5±27.1；无 39.7±55.0；P<0.02）。颈动脉粥样硬化和外周动脉疾病在临界冠状动脉狭窄患者中更为常见。扩张延迟或消失与冠状动脉狭窄和不同程度的冠状动脉粥样硬化有关。动脉扩张的动力学似乎与扩张的幅度一样重要。
