Joannides R, Moore N, Richard V, Godin M, Thuillez C
Service de pharmacologie, VACOMED, IERMP, CHU de Rouen, Hôpital de Bois-Guillaume.
Arch Mal Coeur Vaiss. 1993 Aug;86(8):1219-23.
Although it was usually admitted that hypertension is associated with a reduction in conduit artery compliance and distensibility, recent experiments using newly developed high precision echo-tracking devices allowing simultaneous, non-invasive measurements of blood pressure and arterial diameter have suggested that compliance and distensibility, when calculated at equal transmural pressure, could indeed be maintained, or even increased, in hypertensive subjects. Such a maintained arterial compliance could be explained best by a decrease in wall stress despite the increase in arterial blood pressure, through either an increase in wall thickness or a decrease in arterial wall elastic modulus. Thus, the goal of the present study was to assess the role of the changes in these determinants of vessel compliance in the arterial response to an acute increase in arterial pressure in 7 healthy volunteers. Arterial pressure (AP, Finapress) as well as right radial artery internal diameter and wall thickness (Echo-Tracking, NIUS 2, Asulab) were measured continuously before and after a 2 min cold pressor test (CPT). The following parameters were then calculated at fixed (105 mmHg) pressure from the pressure/diameter curve: compliance (mm2/mmHg) and distensibility (mmHg-1) mid-wall stress (dynes/cm2) and incremental elastic modulus (dynes/cm2). During CPT, mean AP increased (from 83 +/- 4 to 106 +/- 8 mmHg; p < 0.01), compliance distensibility; and mean internal diameter (mm) decreased, mean wall thickness (mm) increased, whereas wall stress and elastic modulus remained unchanged.(ABSTRACT TRUNCATED AT 250 WORDS)
尽管人们普遍认为高血压与传导动脉顺应性和扩张性降低有关,但最近使用新开发的高精度回声跟踪设备进行的实验能够同时无创测量血压和动脉直径,结果表明,在高血压患者中,当在相同跨壁压力下计算时,顺应性和扩张性实际上可以维持甚至增加。尽管动脉血压升高,但通过增加壁厚或降低动脉壁弹性模量,壁应力降低,这可以最好地解释这种维持的动脉顺应性。因此,本研究的目的是评估这些血管顺应性决定因素的变化在7名健康志愿者对动脉压力急性升高的动脉反应中的作用。在2分钟冷加压试验(CPT)前后,连续测量动脉压(AP,Finapress)以及右桡动脉内径和壁厚(回声跟踪,NIUS 2,Asulab)。然后根据压力/直径曲线在固定压力(105 mmHg)下计算以下参数:顺应性(mm2/mmHg)、扩张性(mmHg-1)、中膜壁应力(达因/cm2)和增量弹性模量(达因/cm2)。在CPT期间,平均动脉压升高(从83±4 mmHg升至106±8 mmHg;p<0.01),顺应性、扩张性降低;平均内径(mm)减小,平均壁厚(mm)增加,而壁应力和弹性模量保持不变。(摘要截短于250字)