阻力和导管动脉中的内皮功能和心血管疾病5年风险
Lars Lind1, Lars Berglund, Anders Larsson
1Department of Medical Sciences, Uppsala University Hospital, SE-751 85 Uppsala, Sweden. lars.lind@medsci.uu.se
Circulation
|March 30, 2011
概括
测量阻力动脉中的内皮功能,而不是导管动脉,可以预测心血管事件. 这种血管测量改善了老年人心血管风险预测.
科学领域:
- 心血管医学 心血管医学
- 血管生物学 血管生物学
- 老年学是指老年学的学科.
背景情况:
- 损坏的内皮功能是已知的心血管疾病 (CVD) 的贡献者.
- 对于不同动脉类型的内皮功能与一般人群中发生的心血管疾病之间的关系的了解有限.
- 缺乏对可用的内皮功能评估技术进行比较.
研究的目的:
- 为了比较不同的内皮功能测量方法,预测发生的心血管疾病.
- 评估内皮功能在阻力和导管动脉与心血管事件在老年人队列中的关联.
主要方法:
- 采用了三种不同的方法来测量内皮依赖的血管扩张:侵入性前臂技术 (乙胆),臂动脉超声波 (流媒体扩张) 和脉冲波分析 (terbutaline挑).
- 随访了来自乌普萨拉老年人血管前性研究 (PIVUS) 的1016名参与者 (70岁) 5年,记录了心肌梗塞,中风或死亡的复合终点.
- 利用后勤回归,调整心血管风险因素和药物,分析内皮功能测量和事件风险之间的关联.
主要成果:
- 评估阻力动脉血管扩张的侵入性前臂技术与心血管事件的风险降低显著相关 (OR 0.72 per SD;P=0.01).
- 通过手臂动脉超声波和脉冲波分析测量的内皮功能与复合终点没有显著关系.
- 将侵入性前臂技术的内皮依赖血管扩张纳入"弗雷明汉风险评分"提高了对心血管事件风险的歧视.
结论:
- 对抗性动脉的内皮依赖性血管扩张,通过侵入性评估,是老年人5年心血管风险的独立预测因子.
- 在这个队列中,臂管动脉的流媒体扩张与未来的心血管事件无关.
- 这种血管评估方法在老年人群中添加到现有的心血管风险得分时,可以改善风险分层.
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