Bonfioli Giovanni Battista, Rodella Luca, Rosati Roberta, Carrozza Alberto, Metra Marco, Vizzardi Enrico
Department of Medical and Surgical Specialties, Radiological Sciences and Public Health, ASST Spedali Civili di Brescia, Cardiology University of Brescia, 25123 Brescia, Italy.
J Clin Med. 2023 Jun 9;12(12):3949. doi: 10.3390/jcm12123949.
The aorta and aortic wall have a complex biological system of structural, biochemical, biomolecular, and hemodynamic elements. Arterial stiffness could be considered a manifestation of wall structural and functional variations, and it has been revealed to have a strong connection with aortopathies and be a predictor of cardiovascular risk, especially in patients affected by hypertension, diabetes mellitus, and nephropathy. Stiffness affects the function of different organs, especially the brain, kidneys, and heart, promoting remodeling of small arteries and endothelial dysfunction. This parameter could be easily evaluated using different methods, but pulse-wave velocity (PWV), the speed of transmission of arterial pressure waves, is considered the gold standard for a good and precise assessment. An increased PWV value indicates an elevated level of aortic stiffness because of the decline in elastin synthesis and activation of proteolysis and the increase in fibrosis that contributes to parietal rigidity. Higher values of PWV could also be found in some genetic diseases, such as Marfan syndrome (MFS) or Loeys-Dietz syndrome (LDS). Aortic stiffness has emerged as a major new cardiovascular disease (CVD) risk factor, and its evaluation using PWV could be very useful to identify patients with a high cardiovascular risk, giving some important prognostic information but also being used to value the benefits of therapeutic strategies.
主动脉及主动脉壁拥有一个由结构、生化、生物分子及血流动力学要素构成的复杂生物系统。动脉僵硬度可被视为血管壁结构与功能变化的一种表现，并且已被揭示与主动脉病变存在紧密联系，还是心血管风险的一个预测指标，尤其是在患有高血压、糖尿病和肾病的患者中。僵硬度会影响不同器官的功能，特别是大脑、肾脏和心脏，促进小动脉重塑及内皮功能障碍。该参数可通过不同方法轻松评估，但脉搏波速度（PWV），即动脉压力波的传播速度，被视为进行良好且精确评估的金标准。PWV值升高表明由于弹性蛋白合成减少、蛋白水解激活以及导致血管壁僵硬的纤维化增加，主动脉僵硬度升高。在一些遗传性疾病中，如马凡综合征（MFS）或洛伊迪茨综合征（LDS），也可发现较高的PWV值。主动脉僵硬度已成为一种主要的新型心血管疾病（CVD）风险因素，使用PWV对其进行评估对于识别心血管风险高的患者可能非常有用，不仅能提供一些重要的预后信息，还可用于评估治疗策略的益处。
