Aortic arch compliance and idiopathic unilateral vocal fold paralysis.
Aortic arch compliance and idiopathic unilateral vocal fold paralysis.
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主动脉弓顺应性和特发性单侧声带麻痹。
DOI：
10.1152/japplphysiol.00239.2017
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发表时间：
2017
期刊：
影响因子：
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通讯作者：
Barkmeier-Kraemer,JulieM
中科院分区：
文献类型：
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作者：
Behkam,Reza;Roberts,KaraE;Bierhals,AndrewJ;Jacobs,MEileen;Edgar,JuliaD;Paniello,RandalC;Woodson,Gayle;VandeGeest,JonathanP;Barkmeier-Kraemer,JulieM
单侧声带麻痹 (UVP) 的发生与喉返神经 (RLN) 损伤有关，而喉返神经损伤又与吞咽、发声和呼吸功能受损有关。大多数 UVP 病例发生在手术干预后，其中约 12-42% 的病例没有已知的病因（即特发性）。大约三分之二的 UVP 患者出现左侧损伤，诊断为特发性的患者平均发病年龄≥50 岁。鉴于 RLN 与锁骨下血管和主动脉弓血管之间的关联，我们假设血管组织的变化将导致特发性左侧 UVP 患者与无 UVP 患者相比，主动脉顺应性增加。门控 MRI 数据使主动脉弓直径测量值能够根据整个心动周期的血压进行标准化，从而得出主动脉弓顺应性。对左侧特发性 UVP 个体与年龄和性别匹配的正常对照个体之间的依从性进行了比较。三因素析因方差分析显示，特发性左侧UVP患者的主动脉弓顺应性（P=0.02）和一个心动周期内主动脉弓直径变化（P=0.04）均显着高于对照组。正如之前其他文献所证明的，我们的研究结果证实，健康个体和特发性 UVP 患者的依从性随着年龄的增长而降低 (P<0.0001)。未来的研究将调查主动脉顺应性变化参数作为左侧 UVP 发病的潜在因素。新与值得注意单侧声带麻痹是由于喉返神经 (RLN) 功能受损影响呼吸、吞咽和发声而导致的。大部分患有这种疾病的成年人都有特发性病因（即原因不明）。目前的研究确定，被诊断为左侧特发性声带麻痹的个体比年龄和性别匹配的对照组表现出明显更高的依从性。这些开创性的发现表明主动脉弓顺应性水平与 RLN 功能之间存在联系。
Unilateral vocal fold paralysis (UVP) occurs related to recurrent laryngeal nerve (RLN) impairment associated with impaired swallowing, voice production, and breathing functions. The majority of UVP cases occur subsequent to surgical intervention with approximately 12–42% having no known cause for the disease (i.e., idiopathic). Approximately two-thirds of those with UVP exhibit left-sided injury with the average onset at ≥50 yr of age in those diagnosed as idiopathic. Given the association between the RLN and the subclavian and aortic arch vessels, we hypothesized that changes in vascular tissues would result in increased aortic compliance in patients with idiopathic left-sided UVP compared with those without UVP. Gated MRI data enabled aortic arch diameter measures normalized to blood pressure across the cardiac cycles to derive aortic arch compliance. Compliance was compared between individuals with left-sided idiopathic UVP and age- and sex-matched normal controls. Three-way factorial ANOVA test showed that aortic arch compliance (P= 0.02) and aortic arch diameter change in one cardiac cycle (P= 0.04) are significantly higher in patients with idiopathic left-sided UVP compared with the controls. As previously demonstrated by other literature, our finding confirmed that compliance decreases with age (P< 0.0001) in both healthy individuals and patients with idiopathic UVP. Future studies will investigate parameters of aortic compliance change as a potential contributor to the onset of left-sided UVP.NEW & NOTEWORTHYUnilateral vocal fold paralysis results from impaired function of the recurrent laryngeal nerve (RLN) impacting breathing, swallowing, and voice production. A large proportion of adults suffering from this disorder have an idiopathic etiology (i.e., unknown cause). The current study determined that individuals diagnosed with left-sided idiopathic vocal fold paralysis exhibited significantly greater compliance than age- and sex-matched controls. These seminal findings suggest a link between aortic arch compliance levels and RLN function.