目的:探讨高血压患者动态动脉硬化指数(AASI)、相应对称性动态动脉硬化指数(AASI-BPVR)与左心室质量指数(LVMI)、左心房内径(LAD)的相关性。方法:采用常规24 h动态血压监测数据测定及计算286例高血压病患者AASI、AASI-BPVR以及经超声心...目的:探讨高血压患者动态动脉硬化指数(AASI)、相应对称性动态动脉硬化指数(AASI-BPVR)与左心室质量指数(LVMI)、左心房内径(LAD)的相关性。方法:采用常规24 h动态血压监测数据测定及计算286例高血压病患者AASI、AASI-BPVR以及经超声心动图测定左心室舒张末内径、室间隔厚度、左心室后壁厚度、LAD,计算左心室质量、LVMI、相对室壁厚度,同时检测空腹血糖、血脂水平,进行Pearson相关分析及多元线性回归分析。将24 h AASI>中位数(即>0.51)者为A组(n=133),24 hAASI<中位数(即≤0.51)者为B组(n=153)。结果:A组较B组LVMI增加,差异有统计学意义(P<0.05),左心室质量虽较大,但差异无统计学意义(P=0.384);经Pearson相关分析,LVMI、LAD与各动态动脉硬化指数无明显相关,其中24 h AASI-BPVR与LAD相关系数r=0.111,但差异无统计学意义(P=0.057)。结论:AASI、AASI-BPVR不是高血压左心室肥厚及左心房扩大的独立影响因素,目前尚不能作为高血压心脏损害的预测因子。展开更多
Background: Analysis of arterial stiffness (AS) is a good marker of early arterial disease and an important determinant of cardiovascular risk, independent of other traditional cardiovascular risk factors. Carotid-fem...Background: Analysis of arterial stiffness (AS) is a good marker of early arterial disease and an important determinant of cardiovascular risk, independent of other traditional cardiovascular risk factors. Carotid-femoral pulse wave velocity (CfPWV) is the gold standard to evaluate arterial stiffness. There is evidence that patients with rheumatoid arthritis (RA) have a higher arterial stiffness than their age-matched healthy counterparts and thus have higher cardiovascular (CV) risk. However, data on arterial stiffness in African rheumatoid arthritis patients is scarce. Objectives: To determine the patterns of arterial stiffness in rheumatoid arthritis patients in a sub-Saharan African setting, using CfPWV and Augmentation index (AIx). Method: We conducted a case-control study, at the Douala general hospital over four months (February to May 2018) on 63 subjects among which 31 RA patients matched for age and sex with 32 healthy subjects. AIx and CfPWV were determined non-invasively by radial pulse wave analysis and carotid femoral wave analysis respectively, using a sphygmocor Atcor device (SphygmoCor, PWV Medical, Sydney, Australia). Results: The mean age of RA patients was 47 ± 14 years with most of them being females (n = 26, 83.9%). CfPWV was significantly higher in RA patients compared to the control group (mean: 8.85 ± 2.1 vs 7.45 ± 1.38;p ≤ 0.01) as well as was AIx (Median: 33 [26 - 43] vs 26 [20 - 31];p = 0.01). RA (OR: 6.105;95% CI: 1.52 - 24.54;p 1.34;95% CI: 1.14 - 5.17;p = 0.05), elevated CRP levels (OR: 4.01;95% CI: 1.16 - 13.68;p = 0.03) and Hypertension (OR: 5.75;95% CI: 1.24 -11.60;p Conclusion: Arterial stiffness, a well-recognized marker of cardiovascular risk is increased among patients suffering from rheumatoid arthritis when compared to a healthy control group.展开更多
AIM: To investigate the association of arterial wave reflection with coronary flow reserve(CFR) in coronary artery disease(CAD) patients after successful revascularization.METHODS: We assessed 70 patients with angiogr...AIM: To investigate the association of arterial wave reflection with coronary flow reserve(CFR) in coronary artery disease(CAD) patients after successful revascularization.METHODS: We assessed 70 patients with angiographically documented CAD who had undergone recent successful revascularization. We measured(1) reactive hyperemia index(RHI) using fingertip peripheral arterial tonometry(RH-PAT Endo-PAT);(2) carotid to femoral pulse wave velocity(PWVc-Complior);(3) augmentation index(AIx), the diastolic area(DAI%) and diastolic reflection area(DRA) of the central aortic pulse wave(Arteriograph);(4) CFR using Doppler echocardiography; and(5) blood levels of lipoprotein-phospholipase A2(LpPLA2).RESULTS: After adjustment for age, sex, blood pressure parameter, lipidemic, diabetic and smoking status, we found that coronary flow reserve was independently related to AIx(b =-0.38, r = 0.009), DAI(b = 0.36, P = 0.014), DRA(b = 0.39, P = 0.005) and RT(b =-0.29,P = 0.026). Additionally, patients with CFR < 2.5 had higher PWVc(11.6 ± 2.3 vs 10.2 ± 1.4 m/s, P = 0.019), SBPc(139.1 ± 17.8 vs 125.2 ± 19.1 mm Hg, P = 0.026), AIx(38.2% ± 14.8% vs 29.4% ± 15.1%, P = 0.011) and lower RHI(1.26 ± 0.28 vs 1.50 ± 0.46, P = 0.012), DAI(44.3% ± 7.9% vs 53.9% ± 6.7%, P = 0.008), DRA(42.2 ± 9.6 vs 51.6 ± 11.4, P = 0.012) and Lp PLA2(268.1 ± 91.9 vs 199.5 ± 78.4 ng/m L, P = 0.002) compared with those with CFR ≥ 2.5. Elevated Lp PLA2 was related with reduced CFR(r =-0.33, P = 0.001), RHI(r =-0.37, P < 0.001) and DRA(r =-0.35, P = 0.001) as well as increased PWVc(r = 0.34, P = 0.012) and AIx(r = 0.34, P = 0.001). CONCLUSION: Abnormal arterial wave reflections are related with impaired coronary flow reserve despite successful revascularization in CAD patients. There is a common inflammatory link between impaired aortic wall properties, endothelial dysfunction and coronary flow impairment in CAD.展开更多
文摘目的:探讨高血压患者动态动脉硬化指数(AASI)、相应对称性动态动脉硬化指数(AASI-BPVR)与左心室质量指数(LVMI)、左心房内径(LAD)的相关性。方法:采用常规24 h动态血压监测数据测定及计算286例高血压病患者AASI、AASI-BPVR以及经超声心动图测定左心室舒张末内径、室间隔厚度、左心室后壁厚度、LAD,计算左心室质量、LVMI、相对室壁厚度,同时检测空腹血糖、血脂水平,进行Pearson相关分析及多元线性回归分析。将24 h AASI>中位数(即>0.51)者为A组(n=133),24 hAASI<中位数(即≤0.51)者为B组(n=153)。结果:A组较B组LVMI增加,差异有统计学意义(P<0.05),左心室质量虽较大,但差异无统计学意义(P=0.384);经Pearson相关分析,LVMI、LAD与各动态动脉硬化指数无明显相关,其中24 h AASI-BPVR与LAD相关系数r=0.111,但差异无统计学意义(P=0.057)。结论:AASI、AASI-BPVR不是高血压左心室肥厚及左心房扩大的独立影响因素,目前尚不能作为高血压心脏损害的预测因子。
文摘Background: Analysis of arterial stiffness (AS) is a good marker of early arterial disease and an important determinant of cardiovascular risk, independent of other traditional cardiovascular risk factors. Carotid-femoral pulse wave velocity (CfPWV) is the gold standard to evaluate arterial stiffness. There is evidence that patients with rheumatoid arthritis (RA) have a higher arterial stiffness than their age-matched healthy counterparts and thus have higher cardiovascular (CV) risk. However, data on arterial stiffness in African rheumatoid arthritis patients is scarce. Objectives: To determine the patterns of arterial stiffness in rheumatoid arthritis patients in a sub-Saharan African setting, using CfPWV and Augmentation index (AIx). Method: We conducted a case-control study, at the Douala general hospital over four months (February to May 2018) on 63 subjects among which 31 RA patients matched for age and sex with 32 healthy subjects. AIx and CfPWV were determined non-invasively by radial pulse wave analysis and carotid femoral wave analysis respectively, using a sphygmocor Atcor device (SphygmoCor, PWV Medical, Sydney, Australia). Results: The mean age of RA patients was 47 ± 14 years with most of them being females (n = 26, 83.9%). CfPWV was significantly higher in RA patients compared to the control group (mean: 8.85 ± 2.1 vs 7.45 ± 1.38;p ≤ 0.01) as well as was AIx (Median: 33 [26 - 43] vs 26 [20 - 31];p = 0.01). RA (OR: 6.105;95% CI: 1.52 - 24.54;p 1.34;95% CI: 1.14 - 5.17;p = 0.05), elevated CRP levels (OR: 4.01;95% CI: 1.16 - 13.68;p = 0.03) and Hypertension (OR: 5.75;95% CI: 1.24 -11.60;p Conclusion: Arterial stiffness, a well-recognized marker of cardiovascular risk is increased among patients suffering from rheumatoid arthritis when compared to a healthy control group.
文摘AIM: To investigate the association of arterial wave reflection with coronary flow reserve(CFR) in coronary artery disease(CAD) patients after successful revascularization.METHODS: We assessed 70 patients with angiographically documented CAD who had undergone recent successful revascularization. We measured(1) reactive hyperemia index(RHI) using fingertip peripheral arterial tonometry(RH-PAT Endo-PAT);(2) carotid to femoral pulse wave velocity(PWVc-Complior);(3) augmentation index(AIx), the diastolic area(DAI%) and diastolic reflection area(DRA) of the central aortic pulse wave(Arteriograph);(4) CFR using Doppler echocardiography; and(5) blood levels of lipoprotein-phospholipase A2(LpPLA2).RESULTS: After adjustment for age, sex, blood pressure parameter, lipidemic, diabetic and smoking status, we found that coronary flow reserve was independently related to AIx(b =-0.38, r = 0.009), DAI(b = 0.36, P = 0.014), DRA(b = 0.39, P = 0.005) and RT(b =-0.29,P = 0.026). Additionally, patients with CFR < 2.5 had higher PWVc(11.6 ± 2.3 vs 10.2 ± 1.4 m/s, P = 0.019), SBPc(139.1 ± 17.8 vs 125.2 ± 19.1 mm Hg, P = 0.026), AIx(38.2% ± 14.8% vs 29.4% ± 15.1%, P = 0.011) and lower RHI(1.26 ± 0.28 vs 1.50 ± 0.46, P = 0.012), DAI(44.3% ± 7.9% vs 53.9% ± 6.7%, P = 0.008), DRA(42.2 ± 9.6 vs 51.6 ± 11.4, P = 0.012) and Lp PLA2(268.1 ± 91.9 vs 199.5 ± 78.4 ng/m L, P = 0.002) compared with those with CFR ≥ 2.5. Elevated Lp PLA2 was related with reduced CFR(r =-0.33, P = 0.001), RHI(r =-0.37, P < 0.001) and DRA(r =-0.35, P = 0.001) as well as increased PWVc(r = 0.34, P = 0.012) and AIx(r = 0.34, P = 0.001). CONCLUSION: Abnormal arterial wave reflections are related with impaired coronary flow reserve despite successful revascularization in CAD patients. There is a common inflammatory link between impaired aortic wall properties, endothelial dysfunction and coronary flow impairment in CAD.
