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Carotid circumferential wall stress homeostasis in early remodeling: Theoretical approach and clinical application

机译:早期重塑中颈动脉周壁应力动态平衡的理论方法和临床应用

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Purpose.: To assess the influence of cardiovascular risk factors on arterial wall growth and the remodeling process. Methods.: In a theoretical part, we used a well-established relationship linking the rate of thickening of the arterial wall to the circumferential wall stress (CWS) increase. In a clinical part, we measured the intima-media thickness (IMT) in 166 subjects with increased cardiovascular risk score but no treatment for hypertension or hypercholesterolemia, no diabetes, and no cardiovascular disease. Far wall IMT and lumen diameter were measured along the right carotid artery by high-resolution ultrasonography and computerized image analysis. Results.: A decreasing linear relationship between IMT and CWS was deduced from the theoretical model, implying that an increase in CWS would result in an IMT increase, and that the higher the IMT-CWS slope, the higher the thickening response. Subjects with advanced age, renal insufficiency, high 10-year Framingham risk, carotid atherosclerosis, and advanced atherosclerosis at other sites had sharper IMT-CWS slope (p < 0.05), in agreement with the homeostasis of CWS hypothesis. Conclusions.: The IMT increase responding to a CWS increase was greater in high-risk patients.
机译:目的:评估心血管危险因素对动脉壁生长和重塑过程的影响。方法:在理论部分,我们使用了一种公认的关系,将动脉壁的增厚速率与周壁应力(CWS)的增加联系起来。在临床部分,我们测量了166位心血管疾病风险评分增加但未治疗高血压或高胆固醇血症,无糖尿病且无心血管疾病的受试者的内膜中层厚度(IMT)。通过高分辨率超声检查和计算机图像分析,沿右颈动脉测量远壁IMT和管腔直径。结果:从理论模型推断出IMT和CWS之间线性关系的减小,这意味着CWS的增加将导致IMT的增加,并且IMT-CWS斜率越高,增稠响应也就越高。年龄高,肾功能不全,10年弗雷明汉高风险,颈动脉粥样硬化和其他部位的晚期动脉粥样硬化的受试者的IMT-CWS斜率更陡(p <0.05),与CWS假设的稳态一致。结论:高危患者对CWS升高反应的IMT升高更大。

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