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Asociación entre la presión local del pulso, la presión arterial media y la remodelación de la arteria grande
P Boutouyrie1, C Bussy, P Lacolley
1Departments of Pharmacology, Broussais Hospital, and INSERM U337, Paris, France.
Circulation
|September 29, 1999
Resumen
La presión del pulso local tiene un impacto significativo en la remodelación de la arteria carótida, causando agrandamiento y engrosamiento. Este efecto no se observó en la arteria radial, destacando las respuestas específicas del sitio a la carga mecánica pulsátil.
Área de la Ciencia:
- Fisiología cardiovascular fisiología cardiovascular.
- Biomecánica de las arterias Biomecánica arterial.
- Investigación de la Hipertensión Investigación de la Hipertensión
Sus antecedentes:
- La remodelación arterial está influenciada por las fuerzas hemodinámicas.
- Comprender los roles de la presión de pulso local y la presión arterial media es crucial.
- Las diferencias en la remodelación arterial entre las arterias elásticas y musculares no se comprenden completamente.
Objetivo del estudio:
- Investigar los efectos independientes de la presión del pulso local y la presión arterial media en la remodelación arterial.
- Para comparar estos efectos en una arteria elástica central (arteria carótida común) y una arteria muscular periférica (arteria radial).
Principales métodos:
- Seguimiento de eco de alta definición no invasivo para medir el grosor de los medios íntimos y el diámetro interno.
- Tonometría de aplanamiento para la medición local de la presión del pulso.
- Análisis de regresión multivariado en sujetos sanos y pacientes hipertensos.
Principales resultados:
- El diámetro de la arteria carótida y el grosor de la pared se determinaron significativamente por la presión del pulso carotídeo (P<0.0001).
- La presión arterial media y la presión del pulso braquial no influyeron independientemente en la remodelación carotídea.
- El diámetro de la arteria radial se correlacionó con la edad, mientras que el grosor de la íntima-media se correlacionó con la presión arterial media (P<0,001), no con la presión del pulso radial.
Conclusiones:
- La presión local del pulso es un determinante clave de la remodelación arterial en las arterias elásticas como la arteria carótida común.
- La remodelación arterial en las arterias musculares (arteria radial) se ve influenciada de manera diferente, principalmente por la presión arterial media.
- El estiramiento cíclico puede contribuir a la remodelación inducida por la presión del pulso en las arterias elásticas.
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