The Relationship of Age With Regional Aortic Stiffness and Diameter
The Relationship of Age With Regional Aortic Stiffness and Diameter
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DOI：
10.1016/j.jcmg.2010.09.016
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发表时间：
2010-12-01
影响因子：
14
通讯作者：
Wilkinson, Ian B.
中科院分区：
文献类型：
--
作者：
Hickson, Stacey S.;Butlin, Mark;Wilkinson, Ian B.
本研究的目的是确定年龄对局部主动脉脉搏波速度（aPWV）的影响。背景aPWV是心血管风险的独立预测因子，并随年龄呈指数增长。然而，目前还不清楚这种变化是否发生均匀沿着的长度的主动脉或不同region.METHODS共162名受试者，年龄在18至77岁，无心血管疾病和药物治疗，被招募的盎格鲁-加的夫合作试验。在5个主动脉节段进行电影相位对比磁共振成像。测量每个节段的动脉直径和平均血流量，并测量区域aPWV（通过电影相位对比磁共振成像测量的局部aPWV）在4个主动脉节段中确定：主动脉弓（R1）、胸降主动脉（R2）、降主动脉中段（R3）腹主动脉（R4）结果在4个节段中，由瓣膜到分叉处，电影相位对比磁共振成像测量的区域PWV值逐渐增大（PWV-R1- PWV-R4：分别为4.6 +/- 1.5 m/s、5.5 +/- 2.0 m/s、5.7 +/- 2.3 m/s、6.1 +/- 2.9 m/s），性别间无差异。与年龄相关的最大硬度差异发生在腹主动脉（每十年+0.9 m/s，p < 0.001），其次是胸降区（+0.7 m/s，p < 0.001）、中降区（+0.6 m/s，p < 0.001）和主动脉弓（+0.4 m/s，p < 0.001）。平均收缩期直径向远端移动时减小（L1-5：分别为3.1 +/- 0.4 cm、2.3 +/-0.3 cm、2.1 +/- 0.3 cm、1.9 +/- 0.2 cm和1.7 +/- 0.2 cm）。收缩期内径随年龄变化的最大值出现在上升区（+0.96 mm/decade，p < 0.001）。在整个主动脉上测量的aPWV值与PWV张力测定法密切相关（R = 0.71，p < 0.001），尽管它们显著低于（平均差异1.7 +/-1.6m/s，p < 0.001）。结论主动脉僵硬度的最大差异发生在腹部区域，而直径的最大差异发生在升主动脉，这可以帮助抵消壁刚度的增加。（J Am科尔心脏病学杂志2010;3：1247-55）（C）美国心脏病学会基金会2010年
OBJECTIVE S The purpose of this study was to determine the impact of age on regional aortic pulse wave velocity (aPWV).BACKGROUND aPWV is an independent predictor of cardiovascular risk and increases exponentially with age. However, it is unclear whether such changes occur uniformly along the length of the aorta or vary by region.METHODS A total of 162 subjects, aged 18 to 77 years and free of cardiovascular disease and medication, were recruited from the Anglo-Cardiff Collaborative Trial. Cine phase contrast magnetic resonance imaging was performed at 5 aortic levels. Systolic diameter and average blood flow were measured at each level and regional aPWV (regional aPWV measured by cine phase contrast magnetic resonance imaging) determined in 4 aortic segments: the arch (R1), the thoracic-descending aorta (R2), mid-descending aorta (R3), and the abdominal aorta (R4) and across the entire aorta.RESULTS Regional PWV measured by cine phase contrast magnetic resonance imaging values increased from the valve to the bifurcation in the 4 segments (PWV-R1- PWV-R4: 4.6 +/- 1.5 m/s, 5.5 +/- 2.0 m/s, 5.7 +/- 2.3 m/s, 6.1 +/- 2.9 m/s, respectively) and did not differ between genders. The greatest age-related difference in stiffness occurred in the abdominal aorta (+0.9 m/s per decade, p < 0.001) followed by the thoracic-descending region (+0.7 m/s, p < 0.001), the mid-descending region (+0.6 m/s, p < 0.001) and aortic arch (+0.4 m/s, p < 0.001). The average systolic diameters decreased moving distally (L1-5: 3.1 +/- 0.4 cm, 2.3 +/- 0.3 cm, 2.1 +/- 0.3 cm, 1.9 +/- 0.2 cm, and 1.7 +/- 0.2 cm, respectively). The greatest variation in systolic diameter as a function of age occurred in the ascending region (+0.96 mm/decade, p < 0.001). Values of aPWV measured across the entire aorta were strongly correlated with PWV-tonometry (R = 0.71, p < 0.001), although they were significantly lower (mean difference 1.7 +/- 1.6 m/s, p < 0.001).CONCLUSIONS The greatest difference in aortic stiffness occurs in the abdominal region, whereas the greatest difference in diameter occurs in the ascending aorta, which may help offset an increase in wall stiffness. (J Am Coll Cardiol Img 2010;3:1247-55) (C) 2010 by the American College of Cardiology Foundation