血液动力负荷和心血管事件的组成部分:弗雷明汉心脏研究
Leroy L Cooper1, Jian Rong1, Emelia J Benjamin1
1From Cardiovascular Engineering Inc, Norwood, MA (L.L.C., G.F.M.); Cardiovascular Research Center, Rhode Island Hospital, W. Alpert Medical School of Brown University, Providence, RI (L.L.C.); Boston University and NHLBI's Framingham Study, Framingham, MA (J.R., E.J.B., M.G.L., D.L.); Cardiology and Preventive Medicine Sections, Department of Medicine, Boston University School of Medicine, Boston, MA (E.J.B., R.S.V.); Department of Mathematics and Statistics, Boston University, Boston, MA (M.G.L., R.S.V.); Center for Population Studies, National Heart, Lung, and Blood Institute, Bethesda, MD (D.L.); and Evans Department of Medicine (J.A.V., N.M.H., R.S.V.), Whitaker Cardiovascular Institute (J.A.V., N.M.H., R.S.V.), Boston University School of Medicine, Boston, MA.
前向压力波振幅是对大动脉硬度的衡量标准,与较高的心血管疾病 (CVD) 风险有关. 在这项研究中,平均动脉压和波反射与心血管疾病风险增加无关.
科学领域:
- 心血管生理学心血管生理学
- 血液动力学 血液动力学
- 流行病学 流行病学
背景情况:
- 血压升高是心血管疾病 (CVD) 和过早死亡的主要可改变的风险因素.
- 血压波形具有明显的血液动力学组成部分,它们可能独立地导致不良结果.
- 压力流量测量在大规模的社区群体中没有得到广泛的研究.
研究的目的:
- 为了研究血压波形和发生心血管疾病的血液动力学组成部分之间的关联.
- 检查前向压力波幅,平均动脉压和全球波反射对心血管疾病风险的独立贡献.
主要方法:
- 利用波分离分析和回声心脏学在2492名参与者从弗雷明汉心脏研究.
- 采用比例危险模型来评估心血管疾病事件与血液动力学参数的关联.
- 根据多种心血管风险因素进行调整,包括年龄,性别,BMI,胆固醇,吸烟,糖尿病和抗高血压治疗.
主要成果:
- 在多变量调整后,向前的压力波振幅与发生的心血管疾病有显著的关联 (HR,1.40;P=0.0003).
- 平均动脉压 (HR,1.10;P=0.25) 和全球波反射 (HR,0.93;P=0.58) 并没有与发生的心血管疾病有显著的关联.
- 即使在模型中包括静脉血压和脉冲波速度 (HR,1.33;P=0.02) 之后,向前的压力波幅仍然是心血管疾病事件的显著相关值.
结论:
- 增加的前向压力波幅,反映近道大动脉几何和刚性,与发生心血管疾病的风险更高有关.
- 阻力血管功能指标的平均动脉压和相对波反射与该队列中心血管疾病风险增加无关.
相关概念视频
Pathophysiology of Cardiac Performance
Regulation of Stroke Volume
Preload refers to the degree of stretch on the heart before it contracts. It's analogous to the stretching of a rubber band; the more it's stretched, the more forcefully it snaps back. This concept is encapsulated in the Frank-Starling law of the...
Imbalances in Cardiac Output
CHF can occur due to the failure of either side of the heart. Left-side failure leads to pulmonary congestion—the right side continues to send blood...
Cardiac Output II: Effect of Stroke Volume on Cardiac Output
Preload
Preload refers to the initial elongation of the cardiac myocytes before contraction and is related to the volume of blood filling the heart at the end of diastole, or end-diastolic volume. The...
Blood Studies for Cardiovascular System I: Cardiac Biomarkers
The essential diagnostic tools for detecting myocardial necrosis and monitoring individuals suspected of having acute coronary syndrome (ACS) include:
Troponins
Troponins, particularly cardiac troponins I and T, are the most precise and sensitive markers of myocardial injury. They are detectable within 4-6 hours of myocardial injury and remain...
Heart Failure I: Introduction


