Lage S G, Kopel L, Monachini M C, Medeiros C J, Pileggi F, Polak J F, Creager M A
Heart Institute, School of Medicine, University of São Paulo, Brazil.
Am J Cardiol. 1994 Oct 1;74(7):691-5. doi: 10.1016/0002-9149(94)90311-5.
Conduit artery distensibility affects the pulsatile component of afterload and may contribute to impaired left ventricular function in patients with congestive heart failure (CHF). The objectives of this study were to (1) determine whether arterial distensibility is reduced in patients with CHF, and (2) determine whether decreased arterial compliance is related to an abnormality in vascular wall structure (i.e., wall thickness or excessive levels of circulating neurohumoral vasoconstrictors, or both). The study participants included 40 patients with CHF secondary to idiopathic dilated cardiomyopathy and 33 age-matched healthy volunteers. High-resolution ultrasonography was performed to directly visualize the common carotid artery and measure its diameter and wall thickness. Its elastic properties were determined by relating changes in arterial diameter to changes in pressure generated with each heart beat. Carotid artery distensibility was less (14.1 +/- 1.1 vs 25.3 +/- 1.6 10(-6).N-1.m2, p < 0.001) and Young's modulus of elasticity was greater (3.99 +/- 0.51 vs 2.29 +/- 0.23 10(5).N.m-2, p < 0.005) in patients with CHF than in normal subjects. Also, carotid artery wall thickness was increased in patients with CHF. When the entire population was considered, age, wall thickness, and plasma norepinephrine and aldosterone concentrations correlated inversely with distensibility, whereas age and plasma norepinephrine concentration correlated directly with elasticity. Among normal subjects, only age correlated inversely with distensibility; among patients with CHF, only plasma norepinephrine concentration correlated with elasticity. It is concluded that carotid artery distensibility is reduced in patients with CHF.(ABSTRACT TRUNCATED AT 250 WORDS)
传导动脉的扩张性会影响后负荷的搏动成分，并且可能导致充血性心力衰竭（CHF）患者左心室功能受损。本研究的目的是：（1）确定CHF患者的动脉扩张性是否降低；（2）确定动脉顺应性降低是否与血管壁结构异常（即壁厚或循环中神经体液血管收缩剂水平过高，或两者皆有）有关。研究参与者包括40例继发于特发性扩张型心肌病的CHF患者和33例年龄匹配的健康志愿者。采用高分辨率超声直接观察颈总动脉，并测量其直径和壁厚。通过将动脉直径的变化与每次心跳产生的压力变化相关联来确定其弹性特性。CHF患者的颈动脉扩张性较低（14.1±1.1 vs 25.3±1.6×10⁻⁶·N⁻¹·m²，p<0.001），杨氏弹性模量较高（3.99±0.51 vs 2.29±0.23×10⁵·N·m⁻²，p<0.005）。此外，CHF患者的颈动脉壁厚度增加。当考虑整个人群时，年龄、壁厚以及血浆去甲肾上腺素和醛固酮浓度与扩张性呈负相关，而年龄和血浆去甲肾上腺素浓度与弹性呈正相关。在正常受试者中，只有年龄与扩张性呈负相关；在CHF患者中，只有血浆去甲肾上腺素浓度与弹性相关。得出结论：CHF患者的颈动脉扩张性降低。（摘要截断于250字）
