Aortic stiffness in young patients with heterozygous familial hypercholesterolemia
Aortic stiffness in young patients with heterozygous familial hypercholesterolemia
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DOI：
10.1016/s0002-8703(98)70274-1
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发表时间：
1998-04-01
影响因子：
4.8
通讯作者：
Toutouzas, P
中科院分区：
文献类型：
--
作者：
Pitsavos, C;Toutouzas, K;Toutouzas, P
背景血脂异常是动脉粥样硬化发展的主要危险因素。主动脉扩张性是左心室功能和冠状动脉血流量的重要决定因素，其在血脂异常患者中可能的改变尚未得到充分研究。我们研究了60个病人，（平均年龄37 ± 11岁），患有杂合子家族性高胆固醇血症且无明显动脉疾病，并将其与20名血脂正常的兄弟姐妹进行比较（平均年龄34 ± 10岁）。测量主动脉弹性的两个指标：主动脉扩张性采用公式：2 x（AoS-AoD）/PP x AoD计算，主动脉僵硬指数采用公式：在（SBP/DBP）/（AoS-AoD）/AoD中，AoS和AoD分别为主动脉根部收缩末期和舒张末期直径，SEP和DBP分别为收缩期和舒张期动脉压，PP是脉搏压。应用二维引导M型超声心动图测量主动脉瓣上3cm处的主动脉根部内径，同时用血压计测量肱动脉血压。相反，与对照组相比，孤立性家族性高胆固醇血症患者的主动脉扩张性显著降低（2.15 +/- 1.72 cm（2）·dynes·10（-6）vs 3.18 +/- 1.58 cm（2）·dynes（-1. 10（-6），p < 0.02），此外，结论在动脉粥样硬化性疾病临床表现出现之前，严重的血脂异常并不明显影响主动脉的大小，但会导致主动脉弹性的损害.
Background Dyslipidemia is a primary risk factor for the development of atherosclerosis. Aortic distensibility is an important determinant of left ventricular function and coronary blood flow whose possible alterations in patients with dyslipidemia have not been fully investigated.Methods To assess the effect of dyslipidemia on the elastic properties of the aorta, we studied 60 patients (mean age 37 +/- 11 years) with heterozygous familial hypercholesterolemia and no manifest arterial disease and compared them with 20 of their normolipidemic siblings (mean age 34 +/- 10 years). Two indexes of the aortic elastic properties were measured: aortic distensibility was calculated by use of the formula: 2 x (AoS-AoD)/PP x AoD, and aortic stiffness index was calculated by use of the formula: In (SBP/DBP)/(AoS-AoD)/AoD, where AoS and AoD ore aortic root end-systolic and end-diastolic diameters, respectively, SEP and DBP are systolic and diastolic arterial pressure, respectively, and PP is pulse pressure. Internal aortic root diameters were measured at 3 cm above the aortic valve by use of two-dimensional guided M-mode transthoracic echocardiography, and arterial pressure was measured simultaneously at the brachial artery by sphygmomanometry.Results The mean aortic systolic and diastolic diameter index did not differ signifficantly between the two groups. In contrast, aortic distensibility was found to be significantly reduced in subjects with isolated familial hypercholesterolemia compared with that in the control group (2.15 +/- 1.72 cm(2).dynes.10(-6)vs 3.18 +/- 1.58 cm(2).dynes(-1).10(-6), p < 0.02), In addition, the mean aortic stiffness index was double in patients with familial hypercholesterolemia compared with that in normolipidemic subjects.Conclusions severe dyslipidemia does not overtly influence aortic dimensions but leads to impairment of aortic elastic properties before the occurrence of clinical manifestations of atherosclerotic disease.