デジタル血管機能と心血管リスク因子の横断的な関係,フレーミングハム心臓研究 (Framingham Heart Study) で
Naomi M Hamburg1, Michelle J Keyes, Martin G Larson
1Cardiology Section, Whitaker Cardiovascular Institute, School of Medicine, Boston University, Boston, Mass 01702, USA.
Circulation
|May 7, 2008
まとめ
血管拡張機能の尺度であるデジタルパルス振幅増幅は,心血管リスク要因と関連しています. この研究では,パルス振幅とBMI,コレステロール,糖尿病,喫煙などの要因との関係を調査した.
科学分野:
- 心血管生理学 心血管の生理学
- 血管機能評価について
- エピデミオロジー エピデミオロジー
背景:
- デジタルパルス振幅の増幅は,部分的に酸化窒素によって媒介される,外周血管拡張機能の新しい尺度です.
- ベースラインのデジタルパルス振幅は,外周動脈のトーンを反映します.
- デジタルパルス幅度,高血圧反応,および心血管リスク因子の間のコミュニティレベルの関係はよく理解されていません.
研究 の 目的:
- デジタルパルス振幅とデジタル高血圧反応と心血管リスク因子の関連性を調査する.
- デジタルパルス振幅測定の臨床的有用性と予測的価値を調査する.
主な方法:
- 指先の周辺動脈トノメトリー (PAT) を使って1957年のデジタルパルス振幅を測定した.
- 前腕カフの閉塞によって誘発された反応性高血圧の評価,脈拍幅の変化を時間とともに測定する.
- PAT比 (パルス振幅比の対数) を計算して,高血圧反応を定量化し,ベースラインと全身的効果を調整した.
主要な成果:
- 心血管疾患のリスク要因は,90秒から120秒の膨張後の間隔でPAT比率と最も強い関係を示しました.
- 男性の性別,より高いボディマス指数,高値の総コレステロールとHDLコレステロールの比率,糖尿病,喫煙,および脂質低下治療はPAT比率と逆に関連していました.
- 年齢の増加は,PAT比率と正に関連しており,血管応答の変化を示しています.
結論:
- 反応性高血症は,指先のパルス振幅の時間依存の増加を示しています.
- PAT比で測定されるデジタル血管拡張機能は,複数の伝統的なおよび代謝性心血管リスク要因と有意に関連しています.
- 心血管リスク評価におけるデジタルパルス振幅の臨床的有用性と予測的価値を確立するために,さらなる研究が必要である.
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