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主动脉瓣狭窄后主动脉扩张时的主动脉扩张性:并存冠状动脉疾病的影响。

Aortic distensibility in post-stenotic aortic dilatation: the effect of co-existing coronary artery disease.

作者信息

Stefanadis C, Wooley C F, Bush C A, Kolibash A J, Boudoulas H

机构信息

Division of Cardiology, Ohio State University, Columbus.

出版信息

J Cardiol. 1988 Mar;18(1):189-95.

PMID:3221308
Abstract

Aortic distensibility is decreased in patients with coronary artery disease (CAD) and the angiographically normal aorta. To determine if the same is true in patients with aortic stenosis and post-stenotic dilatation, two groups were studied. Group A consisted of 15 patients with post-stenotic aortic dilatation and normal coronary arteries, and group B, 14 patients with post-stenotic aortic dilatation and CAD. The patients were compared to 18 normal subjects. The area of the first 6 cm of the aorta above the valve obtained by aortography was planimetered and the mean diameters were calculated. Distensibility was calculated using the formula: (formula; see text) Distensibility was greater in group A (2.5 +- .4 cm2.dynes-1) compared to group B (1.0 +- 8 cm2.dynes-1, p less than 0.001). Distensibility in normal subjects reported recently from this laboratory (3.4 +- .4 cm2.dynes-1) was greater compared to both groups A and B (p less than 0.001). Thus, distensibility was decreased in patients with post-stenotic aortic dilatation. The further decrease in distensibility in patients with co-existing coronary artery disease may be partially related to abnormal nutrition of the arterial wall since the vasa vasorum of the ascending aorta are derived from the coronary arteries.

摘要

在冠状动脉疾病(CAD)患者以及血管造影显示正常的主动脉患者中,主动脉扩张性降低。为了确定在主动脉瓣狭窄和狭窄后扩张患者中是否也是如此,对两组患者进行了研究。A组由15例狭窄后主动脉扩张且冠状动脉正常的患者组成,B组由14例狭窄后主动脉扩张且患有CAD的患者组成。将这些患者与18名正常受试者进行比较。通过主动脉造影获得瓣膜上方主动脉前6 cm的面积,用求积仪测量并计算平均直径。使用公式计算扩张性:(公式;见正文)A组的扩张性(2.5±0.4 cm²·达因⁻¹)高于B组(1.0±0.8 cm²·达因⁻¹,p<0.001)。本实验室最近报道的正常受试者的扩张性(3.4±0.4 cm²·达因⁻¹)高于A组和B组(p<0.001)。因此,狭窄后主动脉扩张患者的扩张性降低。并存冠状动脉疾病患者扩张性的进一步降低可能部分与动脉壁营养异常有关,因为升主动脉的滋养血管源自冠状动脉。

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