与大动脉脉冲波组件相关的死亡率和心血管终点:个人参与者分析
Gavin R Norton1, De-Wei An2,3,4, Lucas S Aparicio5
1Cardiovascular Pathophysiology and Genomics Research Unit, School of Physiology, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa (G.R.N., A.J.W.).
Hypertension (Dallas, Tex. : 1979)
|February 23, 2024
概括
对大动脉脉冲波的波分离分析显示,前向压力 (Pfor) 和达到峰值压力的时间 (Tfor,Tref) 与心血管事件有关. 时间与前后压力峰值 (Tfor/Tref) 的比率显著改善了心血管风险预测.
科学领域:
- 心血管生理学心血管生理学
- 动脉血动力学 动脉血动力学
- 风险分层是风险的分层.
背景情况:
- 波分离分析允许对大动脉脉冲波组件进行个性化评估.
- 以前对压力高度的研究产生了不同的结果.
- 这项研究研究了前向 (Pfor) 和后向 (Pref) 脉冲波压力及其时间 (Tfor,Tref) 与心血管结果的关联.
研究的目的:
- 评估大动脉脉冲波压力组件与潜在心血管终点的关联.
- 将分析扩展到包括前进和后退波压力峰值的时间.
- 为了确定这些成分是否改善心血管风险预测模型.
主要方法:
- 分析了来自三个国际中央动脉特性数据库风险分层 (IDCARS) 队列的数据.
- 使用SphygmoCor装置进行脉冲波分析,并通过三角法进行波分离.
- 多变量调整的考克斯回归用于评估心血管死亡率和非致命事件的危险比率.
主要成果:
- 分析了2206名参与者 (平均年龄为57.0岁,55.0%是女性).
- 增加的Pfor,Tfor和Tfor/Tref与显著更高的心血管事件风险有关 (HRs在1.25到1.32之间).
- 将Tfor和Tfor/Tref纳入现有风险模型可以提高预测准确度 (∆Uno的C=0.020,P<0.01).
结论:
- 大动脉脉冲波组件,特别是时间与前后压力峰值 (Tfor/Tref) 的比率,可预测复合心血管终点.
- Tfor/Tref显示了风险预测的显著改善.
- 该Tfor/Tref比率可以作为一个有价值的工具来评估增加后负载和心血管风险.
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