一个由结果驱动的脉冲压放大值.
Qi-Fang Huang1, De-Wei An1,2,3, Lucas S Aparicio4
1Department of Cardiovascular Medicine, Shanghai Key Laboratory of Hypertension, Shanghai Institute of Hypertension, State Key Laboratory of Medical Genomics, National Research Center for Translational Medicine, Ruijin Hospital, Shanghai Jiaotong University School of Medicine, Shanghai, China.
概括
腕与大动脉脉压比 (PPA) 低于1.3表示心血管事件的风险增加. 这一发现对60岁以下的女性尤为重要,强调PPA是被低估的危险因素.
科学领域:
- 心血管医学 心血管医学
- 动脉生理学 动脉生理学
- 预防性心脏病学 预防性心脏病学
背景情况:
- 脉冲压放大 (PPA),手臂至大动脉脉冲压比,自然会随着年龄的增长而下降,并受到心血管风险因素的影响.
- 了解PPA在心血管风险分层中的作用对于早期检测和干预至关重要.
研究的目的:
- 通过大量个人参与者的元分析,为PPA建立一个以结果为导向的门.
- 调查PPA与心血管和冠状动脉终点之间的关联.
- 评估电力购买合同在风险分层模型中的附加值.
主要方法:
- 来自国际中央动脉特性风险分层数据库的人口研究 (n=5608) 的个人参与者元分析.
- 对心血管和冠状动脉终点的发病率和多变量调整的危险比率 (HRs) 的评估,基于SphygmoCor软件测量的PPA.
- 使用综合歧视改进 (IDI) 和净重新分类改进 (NRI) 评估的模型改进.
主要成果:
- 显著的风险指标是1.3的PPA值,心血管终点的HR为1.54,冠状动脉终点的HR为2.45 (PPA<1.3对≥1.3).
- 这些发现是强大的,在发现和测试数据集中得到验证,并显示出显著的NRI.
- 在60岁以下的个体中,心血管 (3.86) 和冠状动脉 (6.21) 每个PPA值的终点HR显著高于60岁及以上的个体 (1.19和1.77分别).
- 在较年轻的年龄组 (<60岁) 观察到更高比例的高风险女性 (PPA <1.3).
结论:
- 臂部至中心脉压比低于1.3是心血管和冠状动脉并发症的重要预测因素,独立于传统的风险因素.
- PPA是一个被低估的危险因素,特别是在30-60岁的女性中.
- 使用PPA进行脉冲波分析,为心血管风险分层提供了宝贵的贡献.
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