Nihoyannopoulos P, Joshi J, Athanasopoulos G, Oakley C M
Department of Medicine, Hammersmith Hospital, London, United Kingdom.
Am J Cardiol. 1993 May 15;71(13):1208-12. doi: 10.1016/0002-9149(93)90647-u.
Transesophageal echocardiographic studies were prospectively performed in 152 consecutive patients older than age 40 years referred to the echocardiography laboratory to assess the prevalence of atherosclerosis in the thoracic aorta and relate this to a history of systemic embolization. Forty-four patients (29%) had at least 1 atherosclerotic lesion in the thoracic aorta. This was associated with a higher prevalence of coronary artery disease (78% of all patients with coronary artery disease), carotid artery disease (88% of all patients with carotid artery disease) and peripheral vascular disease (all symptomatic patients). Forty-two of all patients (28%) had systemic emboli, 20 (48%) of whom had at least 1 atheromatous lesion in the thoracic aorta. Conversely, only 24 of 110 patients (22%) without previous systemic emboli had atheromatous lesions (p < 0.001). It is concluded that atherosclerotic lesions in the thoracic aorta can readily be identified with transesophageal echocardiography. The detection of atherosclerotic plaques of the aorta represents a marker of diffuse atherosclerotic disease, often associated with carotid, coronary and peripheral vascular disease and with the occurrence of systemic emboli. Transesophageal echocardiography may be used serially to investigate whether dietary or pharmacologic maneuvers, or both, can shrink established atherosclerotic plaques in the thoracic aorta.
对连续152例年龄大于40岁且转诊至超声心动图实验室的患者进行了经食管超声心动图研究，以评估胸主动脉粥样硬化的患病率，并将其与系统性栓塞病史相关联。44例患者（29%）在胸主动脉至少有1处动脉粥样硬化病变。这与冠状动脉疾病（所有冠心病患者中的78%）、颈动脉疾病（所有颈动脉疾病患者中的88%）和外周血管疾病（所有有症状患者）的较高患病率相关。所有患者中有42例（28%）发生系统性栓塞，其中20例（48%）在胸主动脉至少有1处动脉粥样硬化病变。相反，在110例既往无系统性栓塞的患者中，只有24例（22%）有动脉粥样硬化病变（p<0.001）。结论是经食管超声心动图可轻易识别胸主动脉的动脉粥样硬化病变。主动脉粥样硬化斑块的检测代表了弥漫性动脉粥样硬化疾病的一个标志，常与颈动脉、冠状动脉和外周血管疾病以及系统性栓塞的发生相关。经食管超声心动图可连续用于研究饮食或药物干预措施，或两者同时使用，是否能够缩小胸主动脉中已形成的动脉粥样硬化斑块。
