Impaired carotid and femoral viscoelastic properties and elevated intima-media thickness in peripheral vascular disease
Impaired carotid and femoral viscoelastic properties and elevated intima-media thickness in peripheral vascular disease
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DOI：
10.1016/s0021-9150(02)00042-4
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发表时间：
2002-09-01
期刊：
影响因子：
5.3
通讯作者：
Seifalian, AM
中科院分区：
文献类型：
--
作者：
Cheng, KS;Tiwari, A;Seifalian, AM
工作背景：我们进行了一项研究，以确定下肢周围血管疾病（PVD）本身是否影响动脉粘弹性和颈动脉和股动脉的内膜中层厚度（IMT）。研究方法：采用超声血管壁跟踪系统对35例PVD患者和35例年龄、性别相匹配的对照组进行检查，同时测量颈动脉、股动脉IMT和粘弹性参数。结果如下：PVD受试者的颈动脉弹性显著受损，包括顺应性（平均值（SD）：6.50（2.39）vs 9.93（4.07）%mmHg（-1）× 10（-2），P < 0.001），Petersen弹性模量（1.77（0.69）vs 1.19（0.63）mmHg x 10（3），P = 0.001）和僵硬指数（17.92（7.21）vs 12.10（6.17），P = 0.001）。它们还具有显著改变的股骨弹性特性，包括Petersen弹性模量（5.94（4.98）vs 3.64（3.27）mmHg x 10（3），P = 0.025）和刚度指数（58.42（47.76）vs 36.96（33.43），P = 0.033）。PVD患者颈动脉IMT（0.85（0.35）vs0.59（0.23）mm，P < 0.001）和股动脉IMT（1.05（0.39）vs0.69（0.31）mm，P < 0.001）也显著增高。根据累积总血管风险评分以及年龄、收缩压和舒张压对假定的心血管负荷进行调整后，颈动脉粘弹性指数和颈动脉及股动脉IMT仍具有高度显著性。然而，股骨弹性变量的差异不再明显。结论：PVD本身影响股动脉和颈动脉壁力学和形态类似于其他心血管危险因素和事件。这些参数可为心血管风险评估提供除经典危险因素和Fracket方程之外的进一步信息。事实上，一些指南已经表明，其他因素，如颈动脉扫描可能会影响临床医生的决定干预治疗。(C)2002爱思唯尔科学爱尔兰有限公司保留所有权利。
Background: We undertook a study to determine whether peripheral vascular disease of the lower extremity (PVD) per se affects the arterial viscoelastic properties and intima-media thickness (IMT) of the carotid and femoral arteries. Methods: Thirty-five patients with PVD, 35 age- and gender-matched control subjects were examined with ultrasound scan wall tracking system, with the simultaneous measurement of blood pressure for carotid and femoral IMT and viscoelastic properties. Results: Subjects with PVD have significantly impaired carotid elastic properties including compliance (mean (SD): 6.50 (2.39) vs 9.93 (4.07) %mmHg(-1) x 10(-2), P < 0.001), Petersen's elastic modulus (1.77 (0.69) vs 1.19 (0.63) mmHg x 10(3), P = 0.001) and stiffness index (17.92 (7.21) vs 12.10 (6.17), P = 0.001) when compared to non-PVD controls. They also have significantly altered femoral elastic properties including Petersen's elastic modulus (5.94 (4.98) vs 3.64 (3.27) mmHg x 10(3), P = 0.025) and stiffness index (58.42 (47.76) vs 36.96 (33.43), P = 0.033). The carotid (0.85 (0.35) vs 0.59 (0.23) turn, P < 0.001) and femoral (1.05 (0.39) vs 0.69 (0.31) mm, P < 0.001) IMTs are also significantly elevated in PVD patients. After adjustment for the presumed cardiovascular load assessed on the basis of a cumulative total vascular risk score, as well as age, systolic and diastolic pressure, the carotid viscoelastic indices and the carotid and femoral IMTs remained highly significant. However, the difference in femoral elastic variables was no longer evident. Conclusion: PVD per se affects the femoral and carotid wall mechanics and morphology similarly to other cardiovascular risk factors and events. These parameters may provide further information for cardiovascular risk assessment in addition to the classical risk factors and the Framingham equation. Indeed, some guidelines have suggested that additional factors such as the carotid scan may influence the clinician's decision to intervene with therapy. (C) 2002 Elsevier Science Ireland Ltd. All rights reserved.