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Low wall stress in popliteal artery – other mechanisms responsible for the predilection of aneurysmal dilatation?
Linköpings universitet, Institutionen för medicin och hälsa, Fysiologi. Linköpings universitet, Hälsouniversitetet.
Department of Vascular Surgery, Jönköping Hospital, Jönköping, Sweden.
Clinical Physiology and Nuclearmedicine Unit, Department of Clinical Sciences, Lund University, Malmö, Sweden.
Department of Surgery, Capio Lundby Hospital, Gothenburg, Sweden.
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(Engelska)Manuskript (preprint) (Övrigt vetenskapligt)
Abstract [en]

Introduction: The popliteal artery (PA) is, after aorta, the most common site for aneurysm formation. Why the PA is more susceptible than other peripheral muscular arteries is unknown. We hypothesised that the wall composition, which in turn affects wall properties, as well as the circumferential wall stress imposed on the arterial wall, might differ compared to other muscular arteries. The aim was to study the circumferential wall stress of the PA in healthy subjects with the adjacent muscular common femoral artery (CFA) as a comparison.

Material and Methods: Ninety-four healthy subjects were included in this study (45 males, range 10-78 years and 49 females, range 10-83 years). The lumen diameter (LD) and intima-media thickness (IMT) in the PA and CFA were investigated with a Philips P700 ultrasound device. Together with blood pressure the circumferential wall stress was defined according to the law of Laplace adjusted for IMT.

Results: The diameter increased with age in both PA and CFA (P<.001), with males having larger diameter than females (P<.001). IMT increased with age in both PA and CFA (P<.001), with higher IMT values in males only in PA (P<0.001). The calculated wall stress was unchanged with age in both arteries, but lower in PA than in CFA in both male and female subjects (P<0.001).

Conclusion: This study shows that the popliteal and common femoral artery wall stress is maintained during ageing, probably due to compensatory remodeling response with an increase in arterial wall thickness. However, the stress imposed on the popliteal artery wall is quite low, indicating that other mechanisms than wall stress contribute to the process of pathological arterial dilatation in the popliteal artery.

Nationell ämneskategori
Fysiologi
Identifikatorer
URN: urn:nbn:se:liu:diva-86142OAI: oai:DiVA.org:liu-86142DiVA, id: diva2:574994
Tillgänglig från: 2012-12-07 Skapad: 2012-12-07 Senast uppdaterad: 2018-01-12
Ingår i avhandling
1. Influence of Genetics and Mechanical Properties on Large Arteries in Man
Öppna denna publikation i ny flik eller fönster >>Influence of Genetics and Mechanical Properties on Large Arteries in Man
2013 (Engelska)Doktorsavhandling, sammanläggning (Övrigt vetenskapligt)
Abstract [en]

Arterial pathology is the major contributor to cardiovascular diseases and mortality. The mechanical properties of arteries are independent factors for cardiovascular disease and mortality, where genetics influence the structure of the arterial wall, which may result in change in arterial stiffness. The aims of this thesis were to study the mechanical properties of the popliteal artery (PA) in healthy subjects and the influence of angiotensin-converting enzyme (ACE) polymorphism and Fibrillin-1 (FBN1) polymorphism on large arteries. Further, the impact of FBN1 polymorphism on cardiovascular morbidity and mortality was investigated.

The PA is, after the abdominal aorta, the most common site of aneurysmal development. The PA was studied in healthy subject with ultrasound and the diameter increased and the distensibility decreased with age, with men having lower distensibility than women. This seems not to be the behavior of a true muscular artery but rather of a central elastic artery such as the aorta, and might have implications for the susceptibility to aneurysm formation, as well as the association of dilating disease between the PA and the aorta. The wall stress in the PA was low and unaffected by age, probably caused by a compensatory remodeling response with an increase in wall thickness. This indicates that other mechanisms than wall stress contribute to the process of pathological dilatation in the PA.

The ACE D allele may be associated with abdominal aortic aneurysm. Elderly men with the ACE D allele were associated with increased abdominal aortic stiffness compared to men carrying the I/I genotype. This suggests that the ACE D allele impairs arterial wall integrity, and in combination with local hemodynamic and other genetic factors it may have a roll in aneurysm formation.

The FBN1 2/3 genotype has been associated with increased systolic blood pressure. The FBN1 2/3 genotype in middle-aged men was associated with increased abdominal aortic stiffness and blood pressure which indicates an increased risk for developing cardiovascular disease. The increased presence of plaque in the carotid artery of middle-aged men with the FBN1 2/3 genotype indicates a pathological arterial wall remodeling with a more pronounced atherosclerotic burden, but did however not affect the risk of cardiovascular events and/or death in this population. This relationship needs to be studied further.

Ort, förlag, år, upplaga, sidor
Linköping: Linköping University Electronic Press, 2013. s. 77
Serie
Linköping University Medical Dissertations, ISSN 0345-0082 ; 1340
Nationell ämneskategori
Fysiologi
Identifikatorer
urn:nbn:se:liu:diva-86144 (URN)978-91-7519-761-6 (ISBN)
Disputation
2013-01-25, Orginalet, Qulturum, Hus B4, , Länssjukhuset Ryhov, Jönköping, 09:00 (Svenska)
Opponent
Handledare
Tillgänglig från: 2012-12-07 Skapad: 2012-12-07 Senast uppdaterad: 2019-12-08Bibliografiskt granskad

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