A Study On The Relationship Between Aortic Flexibility And Atherosclerosis

Objective:Studying the possible interrelationships between the structure and function of the large arteries would lead to a better understanding of the pathophysiology of vascular diseases, to a better evaluation of stroke and cardiovascular risks, and thus to the development of more adequate disease prevention strategies. Previous studies on the association between arterial stiffness and atherosclerosis reported conflicting results. This study is aims at investigating the relationships of aortic arterial flexibility assessed by pulse-wave velocity (PWV) with the presence of carotid atherosclerosis (CAS ) ,the relationship of aortic arterial flexibility with carotid plaque echogenicity and with the severity of carotid plaques in elderly, the relationships of PWV and coronary atherosclerosis, providing some reliable information for the clinical application of the measurement of artery function.Materials and methods:1. The target populations were retired military officers and their spouses, aged 60 or above, including 721 individual. Each individual answered a questionnaire, received Doppler echocardiographic examination for carotid IMT and common carotid artery(CCA), external carotid artery(ECA),internal carotid artery(ICA). CAS was defined as IMT>0.9mm or/and carotid atherosclerotic plaques. The populations were divided into two groups: echolucent plaques group and echogenic plaques group based on their echocardiography. A semi quantitative scale score was also used to assess the severity of plaques. Aortic flexibility was assessed by brachial-ankle pulse wave velocity (baPWV )which was measured using an automatic device (VP-1000,Colin,Japan). The appliance of statistical analyses made us realized the relationship between PWV with CAS.2. One hundred and eight patients who were hospitalized for the chest pain from January 2005 and October were performed by coronary angiography. The patients were divided into two groups according to the result of coronary angiography: CAD group and non-CAD group. CAD was diagnosed if diameter stenosis>50 % was found in at least one coronary segment. The CAD group was divided into single- vessel group x dual- vessel group and multiple- vessel group in term of the numbers of coronary artery with lesion.Results:1. Of the CAS patients by ultrasonic examinations, the risk factors between the two groups provided different statistics descriptions with obviously different distributions concerning the age, mean pressure, pulse pressure, PWV, gender, smoking, hypertension. With weather carotid atherosclerosis dependent and carotid atherosclerosis influence factors as covariates, the logistic regression was done to provide the following results: the multivariate odds ratios of CAS versus non-CAS associated with increase of PWV was increased. PWV were found to have a strong positive association with age (r= 0. 42 FKQ. 001), MBP(r=0. 51 /M). 000), PP(r=0. 48 P=Q. 000) and IMT(r=0. 36 /=0. 000). Subjects with rigid plaques had a higher mean PWV compared with those with soft plaques (P<0.001). The other cardiovascular risk factors were not statistically different between subjects with rigid plaques and those with soft plaques. In subjects with rigid plaques, PWV were increased with the severity of plaques and have statistically significant. Figures show subjects with rigid plaques had higher mean PWV compared with those with soft plaques according to gender, age categories, hypertension status.2. The logistic regression showed sex, smoking, PWV are the risk factor influenced on the presence of CAD. PWV were found to have a positive association with severity of CAD(r = 0.307 KO. 005),but the result was disappeared after controlling for major know cardiovascular risk factors. When the severity of CAD was expressed as single-, dual-, or multiple-vessel disease,the multivariate odds ratios of multiple-vessel disease in subjects with PWV>1600cm/s compared to those with PWV <1600cm/s was 5. 734. Conclusion:1. Aortic stiffness had a positive and independent predictor for the presence of CAS in elder. Age and blood pressure were common risk factors resulting in arterial stiffness and CAS. The result that aortic PWV is a strong associated with carotid rigid plaques showed that both alterations of arterial stiffness and rigid plaques are dependent, in part, on the same systemic pathophysiological process.2. Aortic flexibility had a positive relationship with CAD. Subjects with multiple-vessel disease had a more severe aortic stiffness than others.