Svensson Christina, Bjarnegård Niclas, Eriksson Per, Jonasson Hanna, Strömberg Tomas, Sjöwall Christopher, Zachrisson Helene
Department of Clinical Physiology, University Hospital, Linköping, Sweden.
Department of Health, Medicine and Caring Sciences, Division of Diagnostics and Specialist Medicine, Linköping University, Linköping, Sweden.
Front Physiol. 2022 Jul 5;13:926940. doi: 10.3389/fphys.2022.926940. eCollection 2022.
Takayasu arteritis (TAK) is a rare inflammatory disease affecting aorta and its major branches. Ultrasound (US) can detect inflammatory features in the arterial wall, but less is known regarding skin microcirculation and vascular hemodynamics. The aim was to study if assessment of these variables could add valuable information regarding vascular affection in TAK. 17 patients diagnosed with TAK and 17 age- and sex-matched healthy controls were included. Microcirculatory peak oxygen saturation (OxyP) in the skin after induced ischemia was evaluated with laser Doppler flowmetry/diffuse reflectance spectroscopy. Cerebrovascular reserve capacity (CVR) in the brain was assessed with transcranial Doppler (TCD). Pulse waves were recorded in the radial artery by the aid of applanation tonometry, for calculation of central augmentation index (AIx75). Intima-media thickness (IMT) and stenosis/occlusions were evaluated using US in carotid and central arteries. Reduced OxyP (79 ± 8% vs. 87 ± 4%, < 0.001) was seen in patients with TAK regardless of significant arterial stenosis/occlusion or not. Increased AIx75 (22.3 ± 13.6 vs. 9.2 ± 16.3, = 0.01) was seen in TAK patients without significant stenosis/occlusions. No differences were found in CVR, regardless of proximal stenosis. However, signs of a more high-resistance flow profile were seen in arteria cerebri media. Regardless of arterial stenosis or not, impaired microcirculation of the skin and preserved CVR in the brain were found in subjects with TAK. Signs of increased arterial stiffness in the brain and central arteries were observed. The value of these findings for prediction of future cardiovascular events needs to be clarified in further studies.
高安动脉炎（TAK）是一种罕见的炎症性疾病，累及主动脉及其主要分支。超声（US）可检测动脉壁的炎症特征，但对于皮肤微循环和血管血流动力学的了解较少。目的是研究评估这些变量是否能为TAK的血管病变提供有价值的信息。纳入了17例诊断为TAK的患者和17例年龄及性别匹配的健康对照。采用激光多普勒血流仪/漫反射光谱法评估缺血诱导后皮肤的微循环峰值氧饱和度（OxyP）。采用经颅多普勒（TCD）评估脑内脑血管储备能力（CVR）。借助压平式眼压计记录桡动脉的脉搏波，以计算中心增强指数（AIx75）。使用超声评估颈动脉和中央动脉的内膜中层厚度（IMT）以及狭窄/闭塞情况。无论是否存在明显的动脉狭窄/闭塞，TAK患者均出现OxyP降低（79±8%对87±4%，<0.001）。在无明显狭窄/闭塞的TAK患者中观察到AIx75升高（22.3±13.6对9.2±16.3，=0.01）。无论近端狭窄情况如何，CVR均未发现差异。然而，大脑中动脉出现了更高阻力血流模式的迹象。无论是否存在动脉狭窄，TAK患者均存在皮肤微循环受损和脑内CVR保留的情况。观察到脑和中央动脉动脉僵硬度增加的迹象。这些发现对预测未来心血管事件的价值需要在进一步研究中阐明。
