背景:关于心-踝血管指数(CAVI)和心脏高血压介导的器官损伤(HMOD)之间的关系的研究结果,如通过超声心动图评估左心室肥厚(LVH),老年高血压患者很少。我们试图在PressioniMonitorateELoroAssociazioni(PAMELA)研究中使用抗高血压药物治疗的普通人群的高血压比例中调查这一问题。
方法:该研究包括562名参与者中的239名,他们参加了从初始评估开始10年和25年后进行的PAMELA研究的第二次和第三次调查。数据收集包括病史,人体测量参数,office,home,动态血压(BP),血液检查,超声心动图和CAVI测量。
结果:在整个研究样本中(年龄69+9岁,54%的男性),CAVI与年龄呈正相关,office,home,动态收缩压,LV质量(LVM)指数与体重指数(BMI)呈负相关。在多变量分析中,CAVI与LVM指数相关(p<0.05),独立于主要混杂因素。LVH患者表现出明显较高的CAVI(10.62.8vs9.21.8m/sec)。P<0.001),与没有左心房的人相比,左心房直径更大,左心室射血分数更低。9.4m/sec的CAVI值是预测整个样品中LVH的最佳截止值。
结论:我们的研究提供了新的证据,证明在接受治疗的老年高血压患者中,CAVI和LVH之间存在独立的关联,并表明使用这种动脉僵硬度指标不仅可以用于评估血管损害,而且可以分层LVH的风险。
BACKGROUND: Findings regarding the association between Cardio-Ankle Vascular Index (CAVI) and cardiac hypertension-mediated organ damage (HMOD), such as left ventricular hypertrophy (LVH) assessed by echocardiography, in elderly hypertensive patients are scanty. We sought to investigate this issue in the hypertensive fraction of the general population treated with anti-hypertensive drugs enrolled in the Pressioni Monitorate E Loro Associazioni (PAMELA) study.
METHODS: The study included 239 out of 562 participants who attended the second and third surveys of the PAMELA study performed after 10 and 25 years from the initial evaluation. Data collection included medical history, anthropometric parameters, office, home, ambulatory blood pressure (BP), blood examinations, echocardiography, and CAVI measurements.
RESULTS: In the whole study sample (age 69 ± 9 years, 54% males), CAVI was positively correlated with age, office, home, ambulatory systolic BP, LV mass (LVM) index, and negatively associated with body mass index (BMI). In multivariate analysis, CAVI was associated with the LVM index (P < 0.05) independently of major confounders. The participants with LVH exhibited significantly higher CAVI (10.6 ± 2.8 vs. 9.2 ± 1.8 m/s P < 0.001), larger left atrial diameter, and lower LV ejection fraction values than their counterparts without it. The CAVI value of 9.4 m/s was the best cut-off for prediction of LVH in the whole sample.
CONCLUSIONS: Our study provides new evidence of an independent association between CAVI and LVH in treated elderly hypertensive patients and suggests that the use of this metric of arterial stiffness could not only be used to evaluate vascular damage but also to stratify the risk of LVH.