Divisions of Cardiology and Rheumatology, Department of Medicine, University of New Mexico School of Medicine, Cardiology 5-ACC, MSC 10-5550, University of New Mexico, Albuquerque, NM, 87131-0001, USA.
Rheumatol Int. 2019 Jun;39(6):1027-1036. doi: 10.1007/s00296-019-04267-y. Epub 2019 Mar 16.
The progression of atherosclerosis versus arterial stiffness with age within and between arteries has not been defined. Systemic lupus erythematosus (SLE) is a human model of accelerated arterial disease that may permit this determination. 76 SLE patients (69 women, age 37 ± 12 years) and 26 age-and-sex-matched controls (22 women, age 34 ± 11 years) underwent transesophageal echocardiography and carotid ultrasonography for assessment of atherosclerosis [plaques and intima-media thickening (IMT)] and arterial stiffness [increased pressure-strain elastic modulus (PSEM)] of the descending thoracic aorta and carotid arteries. Since IMT is highly associated with plaques, IMT was used as a marker of atherosclerosis to assess its progression in relation with age and PSEM. Aortic and carotid plaques, IMT, and PSEM were greater in patients than in controls (all p ≤ 0.05). Within the aorta and within the carotid arteries, the average percent increases per decade of age for IMT versus PSEM were similar in patients (8.55% versus 9.33% and 3.39% versus 2.46%, respectively) and controls (5.53% versus 6.60% and 4.75% versus 3.49%, respectively) (all p ≥ 0.58). However, in SLE patients, the average percent increases per decade of age for IMT and PSEM were higher in the aorta than in the carotid arteries (8.55% and 9.33% versus 3.39% and 2.46%, respectively, both p ≤ 0.03). In patients with SLE, atherosclerosis and arterial stiffness progress with age parallel to each other within arteries, but divergently between arteries with different anatomy and hemodynamics.
动脉粥样硬化与动脉僵硬度随年龄的进展在动脉内和动脉间尚未明确。系统性红斑狼疮（SLE）是一种加速动脉疾病的人类模型，可能可以确定这一点。76 名 SLE 患者（69 名女性，年龄 37±12 岁）和 26 名年龄和性别匹配的对照者（22 名女性，年龄 34±11 岁）接受经食管超声心动图和颈动脉超声检查，以评估降胸主动脉和颈动脉的动脉粥样硬化[斑块和内膜-中层厚度（IMT）]和动脉僵硬度[压力-应变弹性模量（PSEM）增加]。由于 IMT 与斑块高度相关，因此将 IMT 用作动脉粥样硬化的标志物，以评估其与年龄和 PSEM 的相关性。患者的主动脉和颈动脉斑块、IMT 和 PSEM 均高于对照组（均 p≤0.05）。在主动脉和颈动脉内，患者与对照组相比，IMT 与 PSEM 每十年的平均增长率相似（分别为 8.55%比 9.33%和 3.39%比 2.46%）（均 p≥0.58）。然而，在 SLE 患者中，主动脉的 IMT 和 PSEM 每十年的平均增长率高于颈动脉（分别为 8.55%和 9.33%比 3.39%和 2.46%，均 p≤0.03）。在 SLE 患者中，动脉粥样硬化和动脉僵硬度随年龄在动脉内平行进展，但在具有不同解剖结构和血流动力学的动脉间呈发散性进展。
