Shlimon Kristian, Lindenberger Marcus, Welander Martin, Dangardt Frida, Bjarnegård Niclas
Department of Health, Medicine and Caring Sciences, Division of Diagnostics and Specialist Medicine, Linköping University, Linköping, Sweden.
Department of Cardiology in Linköping, and Department of Health, Medicine and Caring Sciences, Linköping University, Linköping, Sweden.
JVS Vasc Sci. 2022 Aug 6;3:274-284. doi: 10.1016/j.jvssci.2022.06.001. eCollection 2022.
Abdominal aortic aneurysm (AAA) is associated with dilatation of central elastic arteries, while it is uncertain whether peripheral muscular arteries are affected. The aim of this study was to investigate radial artery diastolic lumen diameter (LD), wall thickness, and circumferential wall stress (CWS) in patients with AAA.
We included 130 men with AAA (mean age, 70.4 ± 3.5 years) and 61 men without AAA (mean age, 70.5 ± 3.2 years) in the study. High-frequency ultrasound examination (50 MHz) was used to measure radial artery diameter, wall thickness, and CWS was calculated.
Men with AAA exhibited smaller radial artery LD (2.34 ± 0.42 mm vs 2.50 ± 0.38 mm; < .01), thicker intima (0.094 ± 0.024 mm vs 0.081 ± 0.018 mm; < .001), similar intima-media (0.28 ± 0.05 vs 0.26 ± 0.05 mm; = NS), and lower CWS (42.9 ± 10.2 kPa vs 48.6 ± 11.4 kPa; < .001), compared with controls. Subgroup analyses including all patients showed smaller LD and thicker intima in patients on statin therapy versus no statin therapy and current/ex-smoking versus never smoking. Individuals with hypertension versus no hypertension also presented with thicker intima, but with no difference in LD.
AAAs demonstrated a smaller LD and thicker intima in the radial artery, in contrast with the theory of a general dilating diathesis of the arteries. Apart from AAA, other factors such as atherosclerosis, smoking habits, and hypertension might also be determinants of radial artery caliber and thickness.
The clinical relevance of this study is the added insight into the pathophysiology of abdominal aortic aneurysm (AAA). Today, the management of AAA is focused on reduction of general cardiovascular risk factors and treatment is based on surgical approaches when the AAA is already manifest. By shedding light on unknown pathophysiological aspects of AAA, it will eventually be possible to develop targeted pharmacological treatments to prevent the formation of AAA, to halt disease progression, and to find early cardiovascular markers of AAA.
腹主动脉瘤（AAA）与中心弹性动脉扩张有关，而外周肌性动脉是否受影响尚不确定。本研究旨在调查AAA患者的桡动脉舒张期管腔直径（LD）、管壁厚度和周向壁应力（CWS）。
本研究纳入了130例AAA男性患者（平均年龄70.4±3.5岁）和61例无AAA男性患者（平均年龄70.5±3.2岁）。采用高频超声检查（50MHz）测量桡动脉直径、管壁厚度，并计算CWS。
与对照组相比，AAA男性患者的桡动脉LD较小（2.34±0.42mm对2.50±0.38mm；P<.01），内膜较厚（0.094±0.024mm对0.081±0.018mm；P<.001），内膜中层厚度相似（0.28±0.05对0.26±0.05mm；P=NS），CWS较低（42.9±10.2kPa对48.6±11.4kPa；P<.001）。包括所有患者的亚组分析显示，他汀类药物治疗组与未使用他汀类药物治疗组相比，以及当前吸烟者/既往吸烟者与从不吸烟者相比，患者LD较小，内膜较厚。高血压患者与无高血压患者相比，内膜也较厚，但LD无差异。
与动脉普遍扩张素质的理论相反，AAA患者桡动脉的LD较小，内膜较厚。除AAA外，动脉粥样硬化、吸烟习惯和高血压等其他因素也可能是桡动脉管径和厚度的决定因素。
本研究的临床意义在于对腹主动脉瘤（AAA）病理生理学有了更多的认识。如今，AAA的管理重点在于降低一般心血管危险因素，治疗基于AAA已经出现时的手术方法。通过揭示AAA未知的病理生理方面，最终有可能开发出有针对性的药物治疗方法，以预防AAA的形成、阻止疾病进展并找到AAA的早期心血管标志物。
