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Medicine

Ultraljud Bedömning av endotelberoende blodflödesförtjockning av armartären i klinisk forskning

Published: October 22, 2014 doi: 10.3791/52070
Automatic Translation
1,2,3, 1,2,3, 1,2,3, 1,2,3
1Department of Surgery, University of California, San Francisco, 2Department of Surgery, Veterans Affairs Medical Center, San Francisco, 3VipeRx Lab, Veterans Affairs Medical Center, San Francisco

Abstract

Den vaskulära endotelet är ett monolager av celler som täcker insidan av blodkärlen och ger både strukturella och funktionella roller. Endotelet fungerar som en barriär och förhindrar leukocytadhesion och aggregering, samt för att kontrollera permeabilitet för plasmakomponenter. Funktionellt, påverkar endotel kärlet tonen.

Endoteldysfunktion är en obalans mellan de kemiska ämnen som reglerar fartyg tonen, thombroresistance, cellulär proliferation och mitos. Det är det första steget i ateroskleros och är associerad med kranskärlssjukdom, perifer artärsjukdom, hjärtsvikt, hypertoni och hyperlipidemi.

Den första demonstrationen av endoteldysfunktion inblandade direkt infusion av acetylkolin och kvantitativ koronarangiografi. Acetylkolin binder till muskarina receptorer på endotel-cellytan, vilket leder till en ökning av intracellulärt kalcium och ökad Nitric oxid (NO) produktion. Hos personer med intakt endotel ades vasodilatation observer medan individer med endotelskada upplevt paradoxalt vasokonstriktion.

Det föreligger ett icke-invasiv in vivo-metoden för mätning av endotelfunktion i perifera artärer genom högupplösande B-mode ultrasound. Den endotelfunktion av perifera artärer är nära relaterad till kranskärlsfunktion. Denna teknik mäter förändring i procent diameter i armartären under en period av reaktiv hyperemi efter ischemi.

Denna teknik, som kallas endotelberoende, blodflödesförtjockning (FMD) har värde i kliniska situationer forskning. Dock kan ett antal fysiologiska och tekniska frågor påverka noggrannheten av resultaten och lämpliga riktlinjer för tekniken har publicerats. Trots riktlinjerna fortfarande MKS starkt operatörsberoende och presenterar en brant inlärningskurva.Denna artikel presenterar en standardiserad metod för att mäta MKS i armartären på överarmen och ger förslag för att minska inom operatörs variabilitet.

Materials

Name Company Catalog Number Comments
Philips HD 11XE ultrasound Philips Healthcare
5-12 MHz linear array transducer Philips Healthcare L12-5
Ultrasound gel Parker Laboratories
Vascular Research Tools v.5.0 Medical Imaging Applications, LLC
MIA Gating module Medical Imaging Applications, LLC
Windows XP Microsoft, Inc
Hand-held aneroid manometer Welch Allyn DS66

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Ultraljud Bedömning av endotelberoende blodflödesförtjockning av armartären i klinisk forskning
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Cite this Article

Alley, H., Owens, C. D., Gasper, W.… More

Alley, H., Owens, C. D., Gasper, W. J., Grenon, S. M. Ultrasound Assessment of Endothelial-Dependent Flow-Mediated Vasodilation of the Brachial Artery in Clinical Research. J. Vis. Exp. (92), e52070, doi:10.3791/52070 (2014).

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