Arterial reactivity in lower extremities is progressively reduced as cardiovascular risk factors increase: comparison with upper extremities using magnetic resonance imaging.
Arterial reactivity in lower extremities is progressively reduced as cardiovascular risk factors increase: comparison with upper extremities using magnetic resonance imaging.
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DOI：
10.1016/j.jacc.2006.10.058
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发表时间：
2007-03
影响因子：
24
通讯作者：
H. Silber;J. Lima;D. Bluemke;B. Astor;Sandeep N. Gupta;T. Foo;P. Ouyang
中科院分区：
文献类型：
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作者：
H. Silber;J. Lima;D. Bluemke;B. Astor;Sandeep N. Gupta;T. Foo;P. Ouyang
目的：我们的目的是调查已确定的心血管危险因素与动脉反应性之间的关系在下肢和上肢之间是否存在差异。背景：臂部阻力动脉反应性与心血管危险因素、冠状动脉疾病和事件相关。然而，下肢和上肢血管反应性与增加心血管危险因素的关系尚未确定。方法将82例健康青年（YH） 33例（21 ~ 41岁）、健康老年（OH） 30例（bb0 ~ 50岁）、老年2型糖尿病患者（OD） 19例分为3组。我们使用磁共振成像直接测量静息和闭塞后充血时肱动脉和股动脉的收缩剪切速率、血流和半径。结果静息组肱、股动脉收缩速率、血流及桡骨半径无明显差异。当YH与OH和OH与OD比较时，臂充血剪切率和充血流量归一化为基线半径的函数无统计学差异。相比之下，OH组的股骨充血剪切率和充血流量归一化至基线半径比YH组低（680±236 s−1vs）。（843±157 s−1,p = 0.001，和0.84±0.25 mm1.27/s比1.01±0.16 mm1.27/s, p = 0.001）， OD低于OH（549±183 s−1,p = 0.02，和0.74±0.19 mm1.27/s, p = 0.046）。结论心血管危险因素负担增加的患者下肢动脉反应性逐渐降低，但上肢没有。这可能有助于解释为什么动脉粥样硬化通常在腿部比手臂更严重，并表明在评估早期全球动脉粥样硬化风险方面，腿部可能比手臂更敏感。
ObjectivesOur goal was to investigate whether the association between established cardiovascular risk factors and arterial reactivity differs between the lower and upper extremities.BackgroundResistance artery reactivity in the arm is associated with cardiovascular risk factors, coronary disease, and events. However, the relationship of lower versus upper extremity vasoreactivity to increasing cardiovascular risk factors has not been determined.MethodsWe studied 82 subjects in 3 groups: 33 young healthy (YH) (21 to 41 years), 30 older healthy (OH) (>50 years), and 19 older type 2 diabetic subjects (OD). We directly measured systolic shear rate, flow, and radius in brachial and femoral arteries at rest and during post-occlusion hyperemia using magnetic resonance imaging.ResultsBrachial and femoral systolic shear rate, flow, and radius were similar among the groups at rest. Brachial hyperemic shear rate and hyperemic flow normalized as a function of baseline radius were not statistically different when YH were compared with OH and OH with OD. In contrast, femoral hyperemic shear rate and hyperemic flow normalized to baseline radius were lower in OH than YH (680 ± 236 s−1vs. 843 ± 157 s−1, p = 0.001, and 0.84 ± 0.25 mm1.27/s vs. 1.01 ± 0.16 mm1.27/s, p = 0.001) and lower in OD than OH (549 ± 183 s−1, p = 0.02, and 0.74 ± 0.19 mm1.27/s, p = 0.046).ConclusionsPersons with increasing cardiovascular risk factor burden had progressively reduced arterial reactivity in lower but not upper extremities. This may help to explain why atherosclerosis usually develops more severely in legs than in arms, and suggests that legs may be more sensitive than arms for assessing early global atherosclerotic risk.