颈动脉支架可减少血管壁的纵向移动。

Claudio Carallo, Michela Destito, Paolo Zaffino, Chiara Caglioti, Vittorio Silipo, Paolo Maria De Masi, Agostino Gnasso, Maria Francesca Spadea
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摘要

背景:纵向位移(LD)是动脉壁内膜和外膜在心动周期中的相对运动,可能与动脉粥样硬化有关。它有一个方向,在生理学上,其主要成分相对于动脉流首先是向后的。在此,我们对各种疾病和单侧颈动脉支架存在时的 LD 进行了研究:方法:通过超声波成像对 75 名参与者(150 条动脉)的身体两侧颈动脉进行采集。结果:肥胖(p = 0.5结果:在整个人群中,肥胖(p = 0.001)和颈动脉斑块(p = 0.01)与低密度脂蛋白数量的减少有独立关联。在亚组分析中,健康人(n = 48 个颈动脉)的低密度分别为 143%,存在心血管风险因素者为 129%(n = 34),MACE 患者为 121%(n = 20),支架对侧颈动脉为 119%(n = 24),有支架的颈动脉为 110%(n = 24)。关于LD的方向,在亚组分析中发现,老年(p = 0.001)和患病(p = 0.001)的参与者的LD数量较少(p = 0.001),但在整个人群中仅与年龄有关(p = 0.002):这项观察性研究表明,颈动脉壁层内的低密度随年龄增长、心血管风险因素、心血管疾病和支架的增加而降低。即使支架肯定有益,这些数据也可能对支架再狭窄有所启示,强调了介入研究的必要性。
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Carotid stents reduce longitudinal movements within the vascular wall.

Background: Longitudinal Displacement (LD) is the relative motion of the intima-media upon adventitia of the arterial wall during the cardiac cycle, probably linked to atherosclerosis. It has a direction, physiologically first backward in its main components with respect to the arterial flow. Here, LD was investigated in various disease and in presence of a unilateral carotid stent.

Methods: Carotid acquisitions were performed by ultrasound imaging on both body sides of 75 participants (150 Arteries). LD was measured in its percent quantity and direction.

Results: Obesity (p = 0.001) and carotid plaques (p = 0.01) were independently associated to quantity decrease of LD in the whole population. In a subgroup analysis, it was respectively 143% in healthy (n = 48 carotids), 129% (n = 34) in presence of cardiovascular risk factors, 121% (n = 20) in MACE patients, 119% (n = 24) in the carotid contralateral to a stent, 110% (n = 24) in carotids with stents. Regarding the direction of LD, in a subgroup analysis an inverted movement was identified in aged (p = 0.001) and diseased (p = 0.001) participants who also showed less quantity of LD (p = 0.001), but independently with age only (p = 0.002) in the whole population.

Conclusions: This observational study suggests that LD within carotid wall layers is lower additively with ageing, cardiovascular risk factors, cardiovascular diseases, and stent. Even if stent is surely beneficial, these data might shed some light on stent restenosis, emphasising the need for interventional studies.

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