Endothelial dysfunction, intima-media thickness and coronary reserve in relation to risk factors and Framingham score in patients without clinical atherosclerosis
Endothelial dysfunction, intima-media thickness and coronary reserve in relation to risk factors and Framingham score in patients without clinical atherosclerosis
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DOI：
10.1097/01.hjh.0000239294.17636.27
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发表时间：
2006-08-01
影响因子：
4.9
通讯作者：
Asin, Enrique
中科院分区：
文献类型：
--
作者：
Campuzano, Raquel;Moya, Jose L.;Asin, Enrique
血管内皮功能障碍、冠状动脉血流储备（CFR）降低和内膜中层厚度（IMT）增加与动脉粥样硬化有关，超声心动图可无创地评估这些参数与心血管风险的关系。91例有心血管危险因素，15例无心血管危险因素。所有病例均排除心血管疾病。应用多普勒超声检测肱动脉内皮依赖性舒张功能、颈总动脉IMT和左前动脉CFR（FMD; 3.7 ± 3.2 vs 11.6 ± 4.4%，P = 0.000）; IMT更大（0.89 +/- 0.3 vs 0.56 +/- 0.14 mm，P = 0.000），CFR更低（2.7 +/- 0.9 vs 4 +/- 1.2，P <0.000）。IMT与FMD、CFR相关性分别为r =-0.240（P = 0.013）、r = -0.384（P = 0.000）、r = 0.289（P = 0.007）。所有IMT大于1 mm的患者均表现为FMD降低，其中大多数患者CFR值较低，但FMD或CFR降低的患者不一定表现为IMT增加。这三个参数与Fracket风险评分之间存在显著相关性。结论在无临床动脉粥样硬化性疾病的患者中，心血管危险因素与FMD、CFR受损和IMT增加有关。尽管发现这些变化之间存在相关性，但它们对心血管危险因素和总体风险的依赖性不同，IMT与Fracket评分相关性最好。
Background Endothelial dysfunction, decreased coronary flow reserve (CFR) and increased intima-media thickness (IMT) are related to atherosclerosis and can be assessed non-invasively by echography.Objectives In order to describe the relationship between these parameters and with cardiovascular risk, this study investigated them simultaneously in patients without clinical atherosclerosis.Methods A total of 106 subjects were studied, 91 with and 15 without cardiovascular risk factors. Cardiovascular disease was excluded in all cases. Doppler ultrasound was used to analyse endothelium-dependent vascular dilation in the brachial artery, IMT in the common carotid artery and CFR in the left anterior artery.Results Patients with cardiovascular risk factors had impaired flow-mediated dilation (FMD; 3.7 +/- 3.2 versus 11.6 +/- 4.4%, P = 0.000); greater IMT (0.89 +/- 0.3 versus 0.56 +/- 0.14 mm, P = 0.000) and lower CFR (2.7 +/- 0.9 versus 4 +/- 1.2, P U 0.000). Correlation was found between IMT and FMD r = -0.240, (P = 0.013), IMT and CFR, r = -0.384 (P = 0.000), and between FMD and CFR of r = 0.289 (P = 0.007). All patients with IMT greater than 1 mm showed depressed FMD, most of them with low values of CFR, but patients with reduced FMD or CFR did not necessarily show increased IMT. There was a significant correlation between the three parameters and the Framingham risk score. Multiple linear regression analysis showed that IMT was the only factor related to the Framingham score.Conclusion In patients without clinical atherosclerotic disease, cardiovascular risk factors are associated with impaired FMD, CFR and increased IMT. Even though a correlation between these changes was found, they showed different dependence on cardiovascular risk factors and with global risk, IMT being the best correlated with the Framingham score.