Aortic Root Dilatation and Aortic Stiffness in Patients With Single Ventricular Circulation
Aortic Root Dilatation and Aortic Stiffness in Patients With Single Ventricular Circulation
复制标题
DOI：
10.1253/circj.cj-13-1264
复制
发表时间：
2014-10-01
影响因子：
3.3
通讯作者：
Senzaki, Hideaki
中科院分区：
文献类型：
--
作者：
Kojima, Takuro;Kuwata, Seiko;Senzaki, Hideaki
背景：本研究验证了这样一种假设，即有单室循环和扩张的患者的主动脉硬度比没有扩张的患者增加得更多，并且在这类患者中，动脉僵硬是主动脉扩张的独立决定因素。方法和结果：连续56例有SIV循环的患者在插管过程中测量了脉搏波速度(PWV)和主动脉大小(主动脉扩张，n=31[观察/预期的主动脉根部直径和GT；1.5]；没有主动脉扩张的患者，n=25)。在控制了年龄和主动脉压后，扩张组的脉搏血容量显著高于非扩张组(483.6±10.3vs.394.0±8.9 cm/S，P<；0.001)。主动脉根部直径与脉搏血流量呈显著正相关(P<；0.001)。在25例直接计算主动脉流量的Glenn前患者中，将主动脉流量(主动脉容量负荷指数)加入自变量的多因素分析显示，Pwv是主动脉扩张的独立决定因素(P<；0.001)。结论：在SIV循环和主动脉扩张的患者中，主动脉僵硬增加，是主动脉扩张的独立决定因素。为了改善Fontan循环的预后，有必要进一步研究调节主动脉僵硬是否能减少主动脉扩张和由此导致的主动脉瓣关闭不全的进展。
Background: This study tested the hypothesis that aortic stiffness is increased more in patients with single ventricular (SiV) circulation and dilated aorta than in those without aortic dilatation, and that aortic stiffness is an independent determinant of aortic dilatation in this type of patient.Methods and Results: Pulse wave velocity (PWV) and aortic size were measured during catheterization in 56 consecutive patients with SiV circulation (aortic dilatation, n = 31 [observed/expected aortic root diameter >1.5]; without aortic dilatation, n = 25). PWV was found to be significantly higher in the dilatation group than in the non-dilatation group (483.6 +/- 10.3 vs. 394.0 +/- 8.9 cm/s, P < 0.001) after controlling for age and aortic pressure, factors known to influence PWV (P < 0.001, analysis of covariance). There was a strong positive correlation between aortic root diameter and PWV (P < 0.001). Multivariate analysis adding aortic flow (index of aortic volume load) to independent variables in 25 pre-Glenn patients with directly calculated aortic flow volume showed that PWV was an independent determinant of aortic dilatation (P < 0.001).Conclusions: In patients with SiV circulation and dilated aorta, aortic stiffness is increased and is an independent determinant of aortic dilatation. To improve prognosis of Fontan circulation, further studies on whether aortic stiffness modulation reduces the progression of aortic dilatation and resultant aortic regurgitation are warranted.