Endothelial dysfunction and systemic inflammation in persons with echolucent carotid plaques
Endothelial dysfunction and systemic inflammation in persons with echolucent carotid plaques
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DOI：
10.1160/th05-11-0772
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发表时间：
2006-07-01
影响因子：
6.7
通讯作者：
Hansen, John-Bjarne
中科院分区：
文献类型：
--
作者：
Noto, Ann-Trude With;Mathiesen, Ellisiv Bogeberg;Hansen, John-Bjarne
颈动脉回声斑块与未来缺血性脑血管事件的高风险相关，与狭窄程度无关。本研究旨在探讨心肌梗死和脑卒中患者斑块形态、组织纤溶酶原激活物抗原（t-PA ag）和血管性血友病因子（vWF）检测的内皮功能障碍与斑块形态的关系，颈动脉狭窄患者的全身炎症。我们进行了一项交叉-横断面研究包括133名颈动脉狭窄患者和138名无狭窄对照者，均来自基于人群的特罗姆phi研究。对两条颈动脉进行高分辨率B型和彩色多普勒/脉冲波多普勒超声检查，并评估斑块回声形态。颈动脉狭窄患者血浆t-PA和vWF浓度显著高于对照组。t-PA ag与斑块回声强度呈显著负相关（p=0.034），颈动脉狭窄患者血浆t-PA ag升高与纤溶酶原激活物-I（PAI-I）升高无关。颈动脉回声斑块患者全身炎症程度更高，血浆t-PA和vWF浓度在WBC、纤维蛋白原和hs-CRR的四分位数上显著升高。我们的研究结果可能表明，血浆t-PA作为内皮功能障碍的标志物可能上级vWF，因为它能够区分各种斑块的回声，t-PAag对心血管疾病的预测作用不依赖于纤溶抑制。
Echolucent carotid plaques are associated with high risk for future ischemic cerebrovascular events independent of the degree of stenosis. Elevated levels of markers of systemic inflammation and endothelial dysfunction are predictors for future myocardial infarction and stroke.The present study was undertaken to investigate the relations between plaque morphology, endothelial dysfunction assessed by tissue-plasminogen activator antigen (t-PA ag) and vonWillebrand factor (vWF), and systemic inflammation in persons with carotid stenosis.We conducted a cross-sectional study including 133 persons with carotid stenosis and 138 controls without stenosis recruited from the population-based Troms phi Study. High-resolution B-mode and colour Doppler/pulsed-wave Doppler ultrasonography of both carotid arteries was performed, and plaque morphology in terms of echogenicity was assessed. Persons with carotid stenosis had significantly higher plasma t-PA and vWF concentrations than controls. There was a significant inverse relationship between t-PA ag and plaque echogenicity (p=0.034).The increased plasma t-PA ag in persons with carotid stenosis was not associated with increased plasminogen activator inhibitor-I (PAI-I). Persons with echolucent carotid plaques had higher degree of systemic inflammation, and plasma t-PA and vWF concentration increased significantly across quartiles of WBC, fibrinogen, and hs-CRR Our findings may suggest that plasma t-PA may be superior to vWF as a marker for endothelial dysfunction due to its ability to discriminate between various plaque echogenicity, and that the predictive role of t-PA ag in cardiovascular disease is independent of inhibited fibrinolysis.