Megnien J L, Simon A, Denarie N, Del-Pino M, Gariepy J, Segond P, Levenson J
Centre de Médecine Préventive Cardiovasculaire and INSERM (CRI), Hôpital Broussais, Paris, France.
Am J Hypertens. 1998 Mar;11(3 Pt 1):293-301. doi: 10.1016/s0895-7061(97)00477-9.
Stiffness of aortic walls has been shown to be a marker of coronary and cerebrovascular diseases in patients with myocardial infarction or stroke. However, its value for predicting preclinical atherosclerosis has not been demonstrated. Therefore, this study tested the association of aortic wall stiffness and coronary and extracoronary atherosclerosis in the absence of clinical cardiovascular disease. In 190 asymptomatic men at cardiovascular risk, carotid-to-femoral pulse wave velocity (PWV) was measured mechanographically and the compliance of the aorta (C), as well as the intrinsic compliance (Ci), was deduced after correction for the effect of blood pressure. Also determined noninvasively were 1) the degree of coronary calcium deposit coded as grade 0, 1, 2, or 3 using ultrafast computed tomography; 2) the extent of extracoronary plaque detected by B-mode echography at three different sites (carotid, abdominal aorta, and femoral) coded as 0, 1, 2, or 3 diseased sites; and 3) the estimated Framingham coronary risk. The grade of coronary calcium was not associated with any aortic elastic parameter. The number of extracoronary diseased sites was not associated with PWV and C but correlated negatively with Ci before but not after age adjustment. The coronary risk correlated positively with PWV and negatively with C before but not after age adjustment and was not associated with Ci. In symptom-free subjects aortic stiffening does not predict the presence of coronary and extracoronary atheroma and therefore cannot be considered as a useful surrogate marker of early atherosclerosis.
主动脉壁僵硬已被证明是心肌梗死或中风患者冠状动脉和脑血管疾病的一个标志物。然而，其在预测临床前动脉粥样硬化方面的价值尚未得到证实。因此，本研究在无临床心血管疾病的情况下，测试了主动脉壁僵硬与冠状动脉和冠状动脉外动脉粥样硬化之间的关联。对190名有心血管风险的无症状男性，用机械方法测量了颈动脉到股动脉的脉搏波速度（PWV），并在校正血压影响后推导出主动脉顺应性（C）以及固有顺应性（Ci）。还通过以下方式进行了非侵入性测定：1）使用超速计算机断层扫描将冠状动脉钙化程度编码为0、1、2或3级；2）通过B型超声在三个不同部位（颈动脉、腹主动脉和股动脉）检测到的冠状动脉外斑块范围，编码为0、1、2或3个病变部位；3）估计的弗雷明汉姆冠心病风险。冠状动脉钙化分级与任何主动脉弹性参数均无关联。冠状动脉外病变部位的数量与PWV和C无关联，但在年龄调整前与Ci呈负相关，年龄调整后则无相关性。冠心病风险在年龄调整前与PWV呈正相关，与C呈负相关，年龄调整后则无相关性，且与Ci无关联。在无症状的受试者中，主动脉僵硬不能预测冠状动脉和冠状动脉外动脉粥样硬化的存在，因此不能被视为早期动脉粥样硬化的有用替代标志物。
