Lehmann E D, Hopkins K D, Rawesh A, Joseph R C, Kongola K, Coppack S W, Gosling R G
From the Department of Imaging, Imperial College, National Heart and Lung Institute, Royal Brompton Hospital; the Academic Department of Radiology, St. Bartholomew's Hospital, London, UK.
Hypertension. 1998 Sep;32(3):565-9. doi: 10.1161/01.hyp.32.3.565.
The aim of this study was to establish the relation between noninvasive Doppler ultrasound assessments of aortic compliance, based on "foot-to-foot" aortic pulse wave velocity measurements, and presumed atherosclerotic load in patients with vascular disease and/or diabetes mellitus. One hundred ten patients with vascular disease and/or diabetes mellitus (arteriopaths) underwent measurement of in vivo aortic compliance using Doppler ultrasound. Demographic data on these subjects were recorded along with details of cardiovascular risk factors and events. Aortic compliance values were compared with data from 51 age-matched healthy, asymptomatic subjects putatively free of vascular disease (controls). Data are expressed as mean+/-SD. Arteriopaths were aged 64.1+/-8.4 years and had total cholesterol levels of 5.9+/-1.1 mmol/L and aortic compliance of 0.78+/-0.42%/10 mm Hg [1.33 kPa]. Most arteriopaths had 2 or more cardiovascular risk factors and events: diabetes (n=41), hypertension (n=45), smoking (n=86), cerebrovascular/transient ischemic event (n=13), myocardial infarction (n=44), angina (n=51), and/or peripheral vascular disease (n=33). Controls were aged 64.3+/-12.1 years with total cholesterol of 6.1+/-1.1 mmol/L and aortic compliance of 1.14+/-0.46%/10 mm Hg [1.33 kPa] (P<0.002 versus arteriopaths). Subset analysis revealed that patients with the greatest number of cardiovascular risk factors and events (n=5) had the stiffest aortas (aortic compliance, 0.58+/-0.15%/10 mm Hg [1.33 kPa]) compared with those patients with the median and mean (n=2) number of risk factors and events (aortic compliance, 0.80+/-0.50%/10 mm Hg [1.33 kPa]; P<0.02). The data suggest that a significant inverse relation exists between presumed atherosclerotic load (as assessed by the number of cardiovascular risk factors and events) and aortic compliance determined noninvasively based on aortic pulse wave velocity measurements. If these findings are confirmed by prospective, longitudinal follow-up studies, such measurements may prove useful as a noninvasive marker of vascular risk.
本研究的目的是基于“足对足”主动脉脉搏波速度测量，建立血管疾病和/或糖尿病患者的无创多普勒超声评估主动脉顺应性与推测的动脉粥样硬化负荷之间的关系。110例血管疾病和/或糖尿病患者（动脉病患者）接受了多普勒超声测量体内主动脉顺应性。记录了这些受试者的人口统计学数据以及心血管危险因素和事件的详细信息。将主动脉顺应性值与51例年龄匹配、假定无血管疾病的健康无症状受试者（对照组）的数据进行比较。数据以平均值±标准差表示。动脉病患者年龄为64.1±8.4岁，总胆固醇水平为5.9±1.1 mmol/L，主动脉顺应性为0.78±0.42%/10 mmHg [1.33 kPa]。大多数动脉病患者有2种或更多心血管危险因素和事件：糖尿病（n = 41）、高血压（n = 45）、吸烟（n = 86）、脑血管/短暂性脑缺血事件（n = 13）、心肌梗死（n = 44）、心绞痛（n = 51）和/或外周血管疾病（n = 33）。对照组年龄为64.3±12.1岁，总胆固醇为6.1±1.1 mmol/L，主动脉顺应性为1.14±0.46%/10 mmHg [1.33 kPa]（与动脉病患者相比，P<0.002）。亚组分析显示，心血管危险因素和事件数量最多的患者（n = 5）的主动脉最僵硬（主动脉顺应性，0.58±0.15%/10 mmHg [1.33 kPa]），而危险因素和事件数量为中位数和平均数的患者（n = 2）（主动脉顺应性，0.80±0.50%/10 mmHg [1.33 kPa]；P<0.02）。数据表明，推测的动脉粥样硬化负荷（通过心血管危险因素和事件的数量评估）与基于主动脉脉搏波速度测量无创确定的主动脉顺应性之间存在显著的负相关。如果这些发现得到前瞻性纵向随访研究的证实，此类测量可能被证明是一种有用的血管风险无创标志物。
