白癜风会诊活动 http://news.39.net/bjzkhbzy/171020/5778539.htmlTODAY今日发布JAMAEarlyRecent,Mar11,今日发布03篇HypertensionApr01,:75(4)今日发布35篇NEJMMar12,:(11)今日发布24篇CirculationResearchEarlyRecent,Mar12,今日发布01篇CirculationEarlyRecent,Mar12,今日发布02篇ATVBEarlyRecent,Mar12,今日发布06篇RECOMMEND推荐阅读01颈动脉分叉结构与动脉粥样硬化斑块易损性的关系ATVBresearch-articlePeirongJiang,ZhensenChen,etc.2小时前等33用户推荐阅读本文Objective:Carotidbifurcationgeometryhasbeenbelievedtobeariskfactorfortheinitiationofatherosclerosisbecauseofitsin?uenceonhemodynamics.However,therelationshipsbetweencarotidbifurcationgeometryandplaquevulnerabilityarenotfullyunderstood.Thisstudyaimedtodeterminetheassociationbetweencarotidbifurcationgeometryandplaquevulnerabilityusingmagneticresonancevesselwallimaging.颈动脉分叉几何结构被认为是动脉粥样硬化的危险因素，因为它影响血流动力学。然而，颈动脉分叉几何结构与斑块易损性之间的关系尚不完全清楚。本研究旨在利用磁共振血管壁成像确定颈动脉分叉几何结构与斑块易损性之间的关系。ApproachandResults:Atotalofcarotidarterieswithnonstenoticatherosclerosiswereincludedfromthecross-sectional,multicenterCAREIIstudy(ChineseAtherosclerosisRiskEvaluation).Fourstandardizedcarotidbifurcationgeometricparameters(bifurcationangle,internalcarotidarteryplanarity,luminalexpansionFlareA,andtortuosityTort2D)werederivedfromtime-of-flightmagneticresonanceimaging.Presenceofvulnerableplaque,whichhasintraplaquehemorrhage,largelipid-richnecroticcore,ordisruptedluminalsurface,wasdeterminedbasedonmulticontrastcarotidmagneticresonancevesselwallimages.Vulnerableplaques(N=43)werefoundtooccuratmoredistallocations(ie,nearthelevelofflowdivider)thanstableplaques(N=).MultivariablelogisticregressionshowsthattheluminalexpansionFlareA(oddsratio,0.45[95%CI,0.25–0.81];P=0.)wasassociatedwithplaquevulnerabilityafteradjustmentforage,sex,maximumwallthickness,plaquelocation,andothergeometricparameters.共有条颈动脉伴非酒精性动脉粥样硬化，均来自横断面多中心CAREII研究（中国动脉粥样硬化风险评估）。从飞行时间磁共振成像中得到了四个标准化的颈动脉分叉几何参数（分叉角、颈内动脉平面度、管腔扩张指数和扭曲度Tort2D）。根据多中心颈动脉磁共振血管壁图像确定是否存在易损斑块，斑块内出血、大量富含脂质的坏死核心或管腔表面破裂。与稳定斑块（N=）相比，脆弱斑块（N=43）出现在更远的位置（即，接近分流水平）。多变量logistic回归显示，经年龄、性别、最大壁厚、斑块位置和其他几何参数调整后，管腔扩张扩张指数（比值比，0.45[95%CI，0.25–0.81]；P=0.）与斑块易损性相关。Conclusions:Smallerluminalexpansionatcarotidbifurcationisassociatedwithvulnerableplaque.Thefindingneedstobeverifiedwithlongitudinalstudiesandtheunderlyingmechanismshouldbefurtherexploredwithhemodynamicsmeasurementinthefuture.颈动脉分叉处管腔扩张较小与易损斑块有关。这一发现有待于纵向研究的证实，其机制有待于今后血液动力学的进一步研究。扫描
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