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(Hypertension. 2001;38:1181.)
© 2001 American Heart Association, Inc.

Fourth Workshop on Structure and Function of Large Arteries: Part II

Compressibility of the Carotid Artery in Patients With Pseudoxanthoma Elasticum

Pierre Boutouyrie; Dominique P. Germain; Anne-Isabelle Tropeano; Brigitte Laloux; Franck Carenzi; Mustapha Zidi; Xavier Jeunemaitre; Stéphane Laurent

From the Department of Pharmacology and INSERM EMI 0107 (P.B., A.I.T., B.L., S.L.) and the Department of Genetics (D.P.G., X.J.), Hôpital Européen Georges Pompidou, Paris, France; and Laboratoire de Mécanique Physique CNRS 7052 (F.C., M.Z.), Creteil, France.

Correspondence to Prof Stéphane Laurent, Service de Pharmacologie et INSERM EMI 0107, Hôpital Européen Georges Pompidou, Assistance Publique Hôpitaux de Paris, 20 Rue Leblanc, 75908 Paris Cedex 15, France. E-mail stephane.laurent{at}egp.ap-hop-Paris.fr

Abstract

Abstract—— The arterial wall has generally been considered as noncompressible in in vitro studies. However, compressibility of the arterial wall (CAW) has never been studied in vivo in humans. Large interstitial proteoglycans play a major role in sustaining the compression generated by pulsatile forces. The aims of the present study were to develop an experimental methodology for the assessment of CAW in vivo in humans and to study CAW in patients with pseudoxanthoma elasticum (PXE), a genetic disease characterized by proteoglycan accumulation and fragmented, swollen, and calcified elastic fibers in connective tissues. We studied 19 female patients with PXE and 15 normal female control subjects matched for age and blood pressure. A high-resolution echo-tracking system was used for the continuous determination of internal diameter and wall thickness at the site of the common carotid artery. Matrices of the radiofrequency signal were analyzed with a dedicated software to measure carotid wall cross-sectional area every 4 milliseconds during 4 to 6 cardiac cycles. CAW was calculated as the stroke change in cross-sectional area. CAW was 44% higher in patients with PXE than in control subjects (6.8±2.6% versus 4.7±2.7%, respectively; P<0.05). In control subjects, CAW decreased with age in a linear manner (r=-0.75, P<0.01). In PXE patients, the relationship with age was not homogeneous: CAW tended to increase with age before 40 years (P=0.07) and significantly decreased with age in older patients (P<0.01). Carotid geometry and elastic properties did not differ between PXE patients and control subjects. In conclusion, CAW was measurable in vivo and noninvasively in humans. The higher CAW of PXE patients compared with that of control subjects suggests that proteoglycans are important determinants of compressibility.

Key Words: proteoglycans • biomechanics • arteries

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