Arterial stiffness

动脉僵硬度
  • 文章类型: Journal Article
    过量的钠消耗导致人类的动脉功能障碍。C57BL/6小鼠品系已用于鉴定过量钠消耗后发生动脉功能障碍的机制。然而,有人担心C57BL/6小鼠对高钠(HS)饮食诱导的高血压具有品系特异性抗性.为了解决这一问题,我们进行了一项荟萃分析,以确定C57BL/6小鼠中钠过量摄入是否会导致动脉功能障碍.在数据库中搜索HS与测量动脉功能的标准饮食研究(即,收缩压[BP],内皮依赖性扩张[EDD],和中央动脉僵硬度)在C57BL/6小鼠中。共纳入39项研究,证明HS条件导致收缩压高于对照小鼠,平均差异为9.8mmHg(95%CI[5.6,14],P<0.001)。亚组分析表明,与遥测的白天相比,夜间测量时,HS的收缩压高于对照组(P<0.001)。我们还发现,通过饮用水给药时,HS和对照组之间的收缩压差异比通过食物给药高〜2.5倍(P<0.001)。共纳入12项研究,证明HS条件导致EDD低于对照组,加权平均差为-12.0%(95%CI[-20.0,-4.1],P=0.003)。应该注意的是,研究之间存在相当大的差异,超过一半的研究显示HS条件对收缩压和EDD没有影响。总之,过量的钠消耗会升高C57BL/6小鼠的收缩压并损害EDD。
    Excess sodium consumption contributes to arterial dysfunction in humans. The C57BL/6 strain of mice have been used to identify mechanisms by which arterial dysfunction occurs after excess sodium consumption. However, there are concerns that C57BL/6 mice have strain-specific resistance to high-sodium (HS) diet-induced hypertension. To address this concern, we performed a meta-analysis to determine if excess sodium consumption in C57BL/6 mice induces arterial dysfunction. Databases were searched for HS vs. standard diet studies that measured arterial function (i.e., systolic blood pressure [BP], endothelium-dependent dilation [EDD], and central arterial stiffness) in C57BL/6 mice. A total of 39 studies were included, demonstrating that HS condition resulted in higher systolic BP than control mice with a mean difference of 9.8 mmHg (95% CI [5.6, 14], P<0.001). Subgroup analysis indicated that the systolic BP was higher in HS compared to the control condition when measured during night compared to daytime with telemetry (P<0.001). We also identified that the difference in systolic BP between HS and control was ~2.5-fold higher when administered through drinking water than through food (P<0.001). A total of 12 studies were included, demonstrating that HS condition resulted in lower EDD than control with a weighted mean difference of -12.0% (95% CI [-20.0, -4.1], P=0.003). It should be noted that there was considerable variability across studies with more than half of the studies showing no effect of HS condition on systolic BP and EDD. In summary, excess sodium consumption elevates systolic BP and impairs EDD in C57BL/6 mice.
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  • 文章类型: Journal Article
    内膜,包括内皮和内皮下基质,在动脉粥样硬化的发病机制中起着至关重要的作用。血流(d流)紊乱和动脉壁变硬引起的机械应力会导致内皮功能障碍。然而,这些物理力对内膜机械环境的具体影响仍不确定。这里,我们研究了抑制胶原交联是否可以改善持续d流对内膜机械性能的不利影响。在C57BL/6J小鼠中进行左颈动脉(LCA)的部分结扎,诱导d流。右颈动脉(RCA)作为内部对照。手术后2天和2周收集颈动脉,以研究d流对内膜机械表型的急性和慢性影响。通过施用β-氨基丙腈(BAPN),d流的慢性作用与随后的动脉壁硬化无关,通过赖氨酰氧化酶(LOX)酶的胶原交联的抑制剂。原子力显微镜(AFM)用于确定面部颈动脉制剂中内皮和内皮下基质的硬度。还确定了在柔软和坚硬的水凝胶上培养的人主动脉内皮细胞(HAEC)的硬度。急性暴露于d流导致雄性小鼠的内皮硬度略有降低,但对两种性别的内皮下基质的硬度均无影响。不管性别,完整的内皮比内皮下基质软。相比之下,暴露于慢性d流导致两种性别的内皮和内皮下僵硬度大幅增加。同时施用BAPN在很大程度上防止了慢性d流的影响。此外,HAEC在柔软与柔软上培养时显示出降低的刚度硬水凝胶。我们得出的结论是,慢性d流导致动脉内膜明显变硬,可以通过抑制胶原交联来有效地防止。
    The intima, comprising the endothelium and the subendothelial matrix, plays a crucial role in atherosclerosis pathogenesis. The mechanical stress arising from disturbed blood flow (d-flow) and the stiffening of the arterial wall contributes to endothelial dysfunction. However, the specific impacts of these physical forces on the mechanical environment of the intima remain undetermined. Here, we investigated whether inhibiting collagen crosslinking could ameliorate the detrimental effects of persistent d-flow on the mechanical properties of the intima. Partial ligation of the left carotid artery (LCA) was performed in C57BL/6J mice, inducing d-flow. The right carotid artery (RCA) served as an internal control. Carotids were collected 2 days and 2 weeks after surgery to study acute and chronic effects of d-flow on the mechanical phenotype of the intima. The chronic effects of d-flow were decoupled from the ensuing arterial wall stiffening by administration of β-aminopropionitrile (BAPN), an inhibitor of collagen crosslinking by lysyl oxidase (LOX) enzymes. Atomic force microscopy (AFM) was used to determine stiffness of the endothelium and the denuded subendothelial matrix in en face carotid preparations. The stiffness of human aortic endothelial cells (HAEC) cultured on soft and stiff hydrogels was also determined. Acute exposure to d-flow caused a slight decrease in endothelial stiffness in male mice but had no effect on the stiffness of the subendothelial matrix in either sex. Regardless of sex, the intact endothelium was softer than the subendothelial matrix. In contrast, exposure to chronic d-flow led to a substantial increase in the endothelial and subendothelial stiffness in both sexes. The effects of chronic d-flow were largely prevented by concurrent BAPN administration. In addition, HAEC displayed reduced stiffness when cultured on soft vs. stiff hydrogels. We conclude that chronic d-flow results in marked stiffening of the arterial intima, which can be effectively prevented by inhibition of collagen crosslinking.
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  • 文章类型: Journal Article
    背景:中国内脏脂肪指数(CVAI)是评估中国人群内脏脂肪组织的新指标。动脉僵硬(AS)是大动脉的一种变性,肥胖是AS的重要因素。我们的研究旨在探讨CVAI与AS风险之间的纵向关联,并比较CVAI的预测能力。体重指数(BMI),和腰围(WC)为AS。
    方法:在2010年至2020年之间,总共有14,877名参与者参与了来自开luan研究的至少两次臂踝脉搏波速度(baPWV)测量。使用Cox比例风险回归模型评估CVAI与AS风险之间的纵向关联。计算受试者工作特征(ROC)曲线下面积以比较CVAI的预测能力,BMI,和WC为AS。
    结果:在调整了潜在的混杂因素后,CVAI与AS的风险显著相关。与第一个CVAI四分位数相比,第二个风险比(HR)和95%CI,第三,第四个四分位数为1.30(1.09-1.56),1.37(1.15-1.63),和1.49(1.24-1.78),分别。CVAI的ROC曲线下面积为0.661,显著高于BMI(AUC:0.582)和WC(AUC:0.606)。
    结论:CVAI可能是确定中国普通人群中AS高危人群的可靠指标,CVAI对AS的预测能力优于BMI和WC。
    BACKGROUND: The Chinese visceral adiposity index (CVAI) is a new index to evaluate visceral adipose tissue in the Chinese population. Arterial stiffness (AS) is a kind of degeneration of the large arteries, and obesity is an essential contributing factor to AS. Our study aimed to explore the longitudinal association between CVAI and the risk of AS and to compare the predictive power of CVAI, body mass index (BMI), and waist circumference (WC) for AS.
    METHODS: Between 2010 and 2020, a total of 14,877 participants participating in at least two brachial-ankle pulse wave velocity (baPWV) measurements from the Kailuan study were included. The Cox proportional hazard regression models were performed to evaluate the longitudinal association between CVAI and the risk of AS. The area under the receiver operating characteristic (ROC) curve was calculated to compare the predictive power of CVAI, BMI, and WC for AS.
    RESULTS: After adjusting for potential confounding factors, CVAI was significantly associated with the risk of AS. Compared with the first CVAI quartile, the hazard ratios (HR) and 95% CI of the second, third, and fourth quartiles were 1.30 (1.09-1.56), 1.37 (1.15-1.63), and 1.49 (1.24-1.78), respectively. The area under ROC curve of CVAI was 0.661, significantly higher than BMI (AUC: 0.582) and WC (AUC: 0.606).
    CONCLUSIONS: CVAI may be a reliable indicator to identify high-risk groups of AS in the Chinese general population, and the predictive power of CVAI for AS was better than BMI and WC.
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  • 文章类型: Journal Article
    虽然观察性研究证明了吸烟之间的联系,酒精消费,动脉僵硬度,由于潜在的混杂因素,建立因果关系已被证明具有挑战性。为了解决这个问题,我们采用了双样本孟德尔随机化方法.
    我们从全基因组关联研究中选择了这些风险因素的遗传工具,这些研究包括3,383,199个个体在全基因组显著性水平(p<5×10-9)。动脉硬度数据来自英国生物库,其中包括127,121名参与者。我们的主要分析使用逆方差加权方法来探索因果关系。为了证实我们的结果的稳健性,我们使用Egger回归进行了敏感性分析,加权中位数法,和孟德尔随机化多效度测量和异常值(MR-PRESSO)。
    我们的分析显示,开始吸烟的遗传倾向与动脉僵硬指数的增加之间存在显着关联(β=0.11;95%置信区间[CI],0.06至0.16;p=1.95×10-5)。此外,基因预测的每日香烟数量与动脉僵硬指数之间存在暗示性联系(β=0.05;95%CI,5.25×10-4~0.10;p=4.75×10-2).在遗传预测的开始吸烟年龄之间没有观察到因果关系,戒烟,或饮酒和动脉僵硬指数的风险。
    这项孟德尔随机化研究表明,开始吸烟可能是动脉僵硬的致病危险因素。然而,需要进一步的研究来确定日常香烟的数量是否直接有助于动脉僵硬的发展。关于酒精消费,开始吸烟的年龄,戒烟,没有足够的证据证明因果关系。
    UNASSIGNED: While observational studies have demonstrated connections between cigarette smoking, alcohol consumption, and arterial stiffness, establishing a causal relationship has proven challenging because of potential confounding factors. To address this problem, we employed a two-sample Mendelian randomization approach.
    UNASSIGNED: We selected genetic instruments for these risk factors from genome-wide association studies encompassing 3,383,199 individuals at the genome-wide significance level (p < 5 × 10 - 9 ). Arterial stiffness data were acquired from the UK Biobank, which included 127,121 participants. Our primary analysis utilized the inverse variance-weighted method to explore causality. To confirm our results\' robustness, we conducted sensitivity analyses using Egger regression, the weighted median method, and Mendelian Randomization Pleiotropy RESidual Sum and Outlier (MR-PRESSO).
    UNASSIGNED: Our analysis revealed a significant association between genetic inclination to smoking initiation and an increase in the arterial stiffness index ( β = 0.11; 95% confidence interval [CI], 0.06 to 0.16; p = 1.95 × 10 - 5 ). Additionally, there was a suggestive connection between genetically predicted number of cigarettes per day and the arterial stiffness index ( β = 0.05; 95% CI, 5.25 × 10 - 4 to 0.10; p = 4.75 × 10 - 2 ). No causal relationships were observed between the genetically predicted age of smoking initiation, smoking cessation, or alcohol consumption and the risk of arterial stiffness index.
    UNASSIGNED: This Mendelian randomization study indicates that smoking initiation is likely a causative risk factor for arterial stiffness. However, further research is needed to determine if the quantity of daily cigarettes directly contributes to arterial stiffness development. Regarding alcohol consumption, age of smoking initiation, and smoking cessation, there was insufficient evidence to establish causality.
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  • 文章类型: Journal Article
    背景:有氧运动如跑步和骑自行车可能通过对中枢血压和血管功能的有利影响来降低心血管疾病(CVD)风险。手臂测功是康复设置中使用的一种流行的锻炼方式,但对这种运动的中枢血流动力学和血管效应知之甚少。
    目的:比较腿部和手臂运动对中心血压和血管功能的急性影响。
    方法:21名参与者(n=11名女性,年龄21±3,BMI24.5±3.2kg/m2)完成了两次对人类表现实验室的访问。中心收缩压(cSBP),中央舒张压(cDBP),和外周增强指数(pAIx)使用肱示波式血压袖带测量,并在急性中等强度(次最大)手臂或腿部自行车运动之前和之后20分钟进行测量。
    结果:pAIx存在随时间变化的相互作用(p=0.011)。pAIx在手臂运动后略有增加,但在腿部运动后显着下降。cDBP存在随时间变化的相互作用(p=0.011)。cDBP在手臂运动后显着降低,但在腿部运动后立即增加。cSBP没有条件与时间的相互作用(p=0.721)。在这两种情况下,运动后立即出现cSBP的急性升高相似。
    结论:与腿部运动相比,手臂运动增加了pAlx,降低了cDBP。由于pAIx的增加可能会增加左心室功,cDBP的减少可能会降低冠状动脉灌注压,这些发现表明,单次手臂锻炼对中枢血流动力学负荷的急性影响可能不如单次腿部锻炼。
    BACKGROUND: Aerobic exercises like running and cycling may lower cardiovascular disease (CVD) risk through favorable effects on central blood pressure and vascular function. Arm ergometry is a popular exercise modality used in rehabilitation settings, but little is known regarding the central hemodynamic and vascular effects of this form of exercise.
    OBJECTIVE: To compare the acute effects of leg versus arm exercise on central blood pressure and vascular function.
    METHODS: Twenty-one participants (n = 11 female, Age 21 ± 3, BMI 24.5 ± 3.2 kg/m2) completed two visits to the Human Performance Laboratory. Central systolic blood pressure (cSBP), central diastolic blood pressure (cDBP), and peripheral augmentation index (pAIx) were measured using a brachial oscillometric blood pressure cuff with measures being taken before and after 20 min of acute moderate-intensity (submaximal) arm or leg cycling exercise.
    RESULTS: There was a condition-by-time interaction for pAIx (p = 0.011). pAIx slightly increased following arm exercise but significantly decreased following leg exercise. There was a condition-by-time interaction for cDBP (p = 0.011). cDBP significantly decreased following arm exercise but increased immediately following leg exercise. There was no condition-by-time interaction for cSBP (p = 0.721). There were similar acute increases in cSBP immediately post-exercise for both conditions.
    CONCLUSIONS: Arm exercise increased pAlx and decreased cDBP compared to leg exercise. As an increase in pAIx may increase left ventricular work and a reduction in cDBP may reduce coronary perfusion pressure, these findings suggest that a single bout of arm exercise may not have the same favorable acute effect on central hemodynamic load as a single bout of leg exercise.
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  • 文章类型: Journal Article
    通过总脉搏波速度(T-PWV)测量的动脉硬度与多种年龄相关疾病的风险增加有关。T-PWV可以通过结构(S-PWV)和负载依赖性(LD-PWV)动脉硬化来描述。T细胞与动脉重塑有关,血压,人类和动物的动脉僵硬度;然而,T细胞是否与S-PWV或LD-PWV相关尚不清楚。因此,我们评估了外周T细胞亚群与T-PWV的横断面关联,S-PWV,和LD-PWV刚度。
    使用流式细胞术对外周血T细胞进行表征,并在多种族动脉粥样硬化研究的一个子集的基线检查中使用B型超声测量颈动脉以计算T-PWV(MESA,n=1,984)。使用参与者特定的指数模型根据弹性模量和血压梯度计算S-PWV和LD-PWV。五个主要(P-显著性<0.01)和二十五个探索性(P-显著性<0.05)免疫细胞亚群之间的关联,每1-SD增量,和动脉僵硬度的测量是使用调整的,线性回归。
    对于主要分析,较高的CD4+CD28-CD57+T细胞与较高的LD-PWV相关(β=0.04m/s,p<0.01)在调整协变量后。对于探索性分析,T细胞亚群通常随着年龄的增长而向记忆和分化/免疫衰老表型转移,与更大的T-PWV相关。S-PWV,以及调整协变量后的LD-PWV。
    在这项横断面研究中,一些通常与衰老相关的T细胞亚群与动脉僵硬度相关.有必要进行纵向研究,以检查T细胞亚群的变化和动脉僵硬度的测量。
    UNASSIGNED: Arterial stiffness measured by total pulse wave velocity (T-PWV) is associated with increased risk of multiple age-related diseases. T-PWV can be described by structural (S-PWV) and load-dependent (LD-PWV) arterial stiffening. T-cells have been associated with arterial remodeling, blood pressure, and arterial stiffness in humans and animals; however, it is unknown whether T-cells are related to S-PWV or LD-PWV. Therefore, we evaluated the cross-sectional associations of peripheral T-cell subpopulations with T-PWV, S-PWV, and LD-PWV stiffness.
    UNASSIGNED: Peripheral blood T-cells were characterized using flow cytometry and the carotid artery was measured using B-mode ultrasound to calculate T-PWV at the baseline examination in a subset of the Multi-Ethnic Study of Atherosclerosis (MESA, n=1,984). A participant-specific exponential model was used to calculate S-PWV and LD-PWV based on elastic modulus and blood pressure gradients. The associations between five primary (p-significance<0.01) and twenty-five exploratory (p-significance<0.05) immune cell subpopulations, per 1-SD increment, and arterial stiffness measures were assessed using adjusted, linear regressions.
    UNASSIGNED: For the primary analysis, higher CD4+CD28-CD57+ T-cells were associated with higher LD-PWV (β=0.04 m/s, p<0.01) after adjusting for co-variates. For the exploratory analysis, T-cell subpopulations that commonly shift with aging towards memory and differentiated/immunosenescent phenotypes were associated with greater T-PWV, S-PWV, and LD-PWV after adjusting for co-variates.
    UNASSIGNED: In this cross-sectional study, several T-cell subpopulations commonly associated with aging were related with measures of arterial stiffness. Longitudinal studies that examine changes in T-cell subpopulations and measures of arterial stiffness are warranted.
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  • 文章类型: Editorial
    暂无摘要。
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  • 文章类型: Journal Article
    银屑病易导致心血管功能障碍。我们调查了糖萼膳食补充剂(GDS)是否,含有糖胺聚糖和岩藻依聚糖,改善银屑病患者的内皮糖萼和动脉僵硬度。50名接受生物制剂治疗的银屑病患者被随机分配到GDS(n=25)或安慰剂(n=25)治疗4个月。我们在基线和随访时测量:(a)舌下微血管的灌注边界区域(PBR)(范围4至25μm),内皮糖萼完整性的标志物;(b)颈动脉-股动脉脉搏波速度(PWV-ComplexiorSP-ALAM)和增强指数(AIx),动脉僵硬度和(c)银屑病面积和严重程度指数(PASI)评分的标志物。两组在4个月时PASI的下降相似(p<0.05),组间差异无统计学意义(p>0.05)。与安慰剂相比,GDS的参与者显示PBR4-25μm的减少百分比更大(-9.95%vs.-0.87%),PBR4-9μm(-6.50%vs.-0.82%),PBR10-19μm(-5.12%vs.-1.60%),PBR20-25μm(-14.9%vs.-0.31%),PWV(-15.27%与-4.04%)和AIX(-35.57%与-21.85%)(p<0.05)。在GDS组中,随访时,PBR4-25μm的百分比降低与PWV(r=0.411,p=0.015)和AIX(r=0.481,p=0.010)的相应降低相关.GDS治疗4个月可改善银屑病患者糖萼完整性和动脉僵硬度。临床试验标识符:NCT05184699。
    Psoriasis predisposes to cardiovascular dysfunction. We investigated whether glycocalyx dietary supplement (GDS), which contains glycosaminoglycans and fucoidan, improves endothelial glycocalyx and arterial stiffness in psoriatic patients. Fifty participants with psoriasis under biological agents were randomly assigned to GDS (n = 25) or placebo (n = 25) for 4 months. We measured at baseline and at follow-up: (a) perfused boundary region (PBR) of the sublingual microvessels (range 4 to 25 μm), a marker of endothelium glycocalyx integrity; (b) carotid-femoral pulse wave velocity (PWV-Complior SP-ALAM) and augmentation index (AIx), markers of arterial stiffness and (c) psoriasis area and severity index (PASI) score. Both groups displayed a similar decrease in PASI at four months (p < 0.05), and no significant differences were found between groups (p > 0.05). Compared to the placebo, participants in the GDS showed a greater percentage reduction in PBR4-25 μm (-9.95% vs. -0.87%), PBR 4-9 μm (-6.50% vs. -0.82%), PBR10-19 μm (-5.12% vs. -1.60%), PBR 20-25 μm (-14.9% vs. -0.31%), PWV (-15.27% vs. -4.04%) and AIx (-35.57% vs. -21.85%) (p < 0.05). In the GDS group, the percentage reduction in PBR 4-25 μm was associated with the corresponding decrease in PWV (r = 0.411, p = 0.015) and AΙx (r = 0.481, p = 0.010) at follow-up. Four-month treatment with GDS improves glycocalyx integrity and arterial stiffness in patients with psoriasis. Clinical trial Identifier: NCT05184699.
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  • 文章类型: Journal Article
    心房肌病-定义为左心房(LA)大小和功能异常-与房颤风险增加相关,心力衰竭,和痴呆症。中央动脉僵硬度与心房后负荷和纤维化增加有关,可能是心房肌病的危险因素。我们检查了颈动脉-股动脉脉搏波速度(cfPWV)与LA功能的关系,并评估了潜在的因果关系。我们纳入了2825名社区动脉粥样硬化风险(ARIC)研究参与者,来自第5次访视(2011-2013)。cfPWV与超声心动图LA功能连续每1-SD相关,并在四分位数中分类。使用与动脉僵硬指数和LA功能的心脏磁共振测量相关的英国Biobank衍生的遗传变异进行孟德尔随机化(MR)分析。当按SD增量(297.6cm/s)分析时,较高的cfPWV与较低的LA储层和导管应变显着相关(β=-0.53%,95%CI[-0.81,-0.25]和β=-0.46%,95%CI[-0.68,-0.25],分别)在调整人口统计后,临床特征,收缩压,左心室(LV)形态和功能。在MR分析中,动脉僵硬度指数与LA总量呈非显着负相关,被动,和主动排空部分。较高的cfPWV与较低的LA储层和导管应变相关,独立于收缩压和LV形态和功能。没有发现动脉僵硬指数与LA功能改变之间存在因果关系的证据。未来的研究应检查中央动脉僵硬度与LA功能改变的前瞻性关联。
    Atrial myopathy-defined as abnormal left atrial (LA) size and function-is associated with an increased risk of atrial fibrillation, heart failure, and dementia. Central arterial stiffness is associated with increased atrial afterload and fibrosis and may be a risk factor for atrial myopathy. We examined the association of carotid-femoral pulse wave velocity (cfPWV) with LA function and assessed potential causal relationships. We included 2825 Atherosclerosis Risk in Communities (ARIC) study participants from Visit 5 (2011-2013). cfPWV was related to echocardiographic LA function continuously per 1-SD and categorically in quartiles. Mendelian randomization (MR) analysis was performed using U.K. Biobank-derived genetic variants associated with arterial stiffness index and cardiac magnetic resonance measures of LA function. When analyzed per SD increment (297.6 cm/s), higher cfPWV was significantly associated with lower LA reservoir and conduit strain (β = -0.53%, 95% CI [-0.81, -0.25] and β = -0.46%, 95% CI [-0.68, -0.25], respectively) after adjusting for demographics, clinical characteristics, systolic blood pressure, and left ventricular (LV) morphology and function. In MR analyses there was a non-significant inverse association of arterial stiffness index with LA total, passive, and active emptying fractions. Higher cfPWV is associated with lower LA reservoir and conduit strain, independent of systolic blood pressure and LV morphology and function. No evidence for a causal relationship between arterial stiffness index and alterations in LA function was found. Future studies should examine the prospective association of central arterial stiffness with LA function alterations.
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  • 文章类型: Journal Article
    背景:通过超声心动图评估动脉僵硬度与左心室(LV)同心重塑/LVH相关的证据,异常血压(BP)表型,社区中由办公室和动态BP监测(ABPM)定义的很少。我们在PressioniMonitorateELoroAssociazioni(PAMELA)研究的参与者中调查了这个问题。
    方法:该研究包括491名参与者,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,血液检查,office,ABPM,超声心动图和心踝血管指数(CAVI)测量。
    结果:在整个研究样本中(年龄66+10岁,50%男性),持续正常值(NT)的患病率,白大衣高血压(WCH),隐性高血压(MH),持续性高血压(SH)和非浸渍性高血压(ND)分别为31.2,10.0,24.2,34.6和35.8%.有SH的可能性,携带最大CV风险的BP表型,与没有器官损伤的参与者相比,CAVI和LV重塑/LVH增加的参与者高出四倍(OR=4.31,CI:2.39-7.76,p<0.0001)。与两种分离的器官损伤标志物相比,这种关联显示出区别SH的递增值(对于CAVI增加,OR=1.92,p=0.03,对于LV重塑/LVH,OR=2.02,p=0.02)。孤立但合并的器官损伤的存在与ND无关。
    结论:我们的研究提供了新的证据,证明在普通人群中寻找血管和心脏器官损伤对优化SH的识别和临床管理具有递增的价值。
    BACKGROUND: Evidence on the association of arterial stiffness and left ventricular (LV) concentric remodelling/ LVH assessed by echocardiography, with abnormal blood pressure (BP) phenotypes, defined by office and ambulatory BP monitoring (ABPM) in the community is scanty. We investigated this issue in the participants to the Pressioni Monitorate E Loro Associazioni (PAMELA) study.
    METHODS: The study included 491 participants who attended the second and third survey of the PAMELA study performed after 10 and 25 years from the initial evaluation. Data collection included medical history, anthropometric parameters, blood examinations, office, ABPM, echocardiographic and Cardio-Ankle Vascular Index (CAVI) measurements.
    RESULTS: In the whole study sample (age 66 + 10 years, 50% males), the prevalence rates of sustained normotension (NT), white coat hypertension (WCH), masked hypertension (MH), sustained hypertension (SH) and non-dipping (ND) were 31.2, 10.0, 24.2, 34.6, and 35.8% and respectively. The likelihood of having SH, the BP phenotype carrying the greatest CV risk, was four times higher (OR= 4.31, CI:2.39-7.76, p<0.0001) in participants with increased CAVI and LV remodelling/LVH compared to their counterparts without organ damage. This association showed an incremental value in discriminating SH compared to both isolated markers of organ damage (OR=1.92,p=0.03 for increased CAVI and OR= 2.02, p=0.02 for LV remodelling/LVH). The presence of isolated but also combined organ damage was unrelated to ND.
    CONCLUSIONS: Our study provides new evidence of the incremental value of looking for both vascular and cardiac organ damage to optimize the identification and clinical management of SH in the general population.
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