与中央动脉压时间指数相关的心血管终点
Qi-Fang Huang1, De-Wei An1, Lucas S Aparicio2
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
中枢动脉压力时间指数,包括静心压 (SPTI) 和静心压 (DPTI),有助于心血管风险分层. 虽然SPTI和DPTI预测心血管事件和中风,但心下内脏活力比率 (SEVR) 却没有.
科学领域:
- 心血管生理学心血管生理学
- 生物医学工程 生物医学工程
- 流行病学 流行病学
背景情况:
- 中心动脉压力-时间指数,如静脉压力 (SPTI) 和静脉压力 (DPTI) 压力-时间指数,以及心下活力比率 (SEVR) 是已知的指标.
- 它们在一般人群中的风险分层中的实用性仍然在很大程度上未被描述.
研究的目的:
- 调查非侵入性测量SPTI,DPTI和SEVR对一般人群心血管结果和中风的预测价值.
- 在心血管风险分层模型中评估这些指数的增量预测值.
主要方法:
- 利用国际中央动脉特性数据库的数据来进行风险分层 (n=5099).
- 使用SphygmoCor技术进行非侵入性测量SPTI,DPTI和SEVR.
- 对心血管终点,心脏终点和中风的评估危险比率 (HRs) 使用多变量调整的考克斯比例危险模型,平均随访时间为4年. 用AUC,IDI和NRI来评估模型的精细化.
主要成果:
- SPTI和DPTI与心血管终点,心脏终点和中风风险增加显著相关 (HRs从1.33到1.74不等).
- SEVR与任何评估的终点都没有显著的关联.
- 将SPTI或DPTI添加到风险模型中改善了歧视,与平均动脉压相结合使用显著增加了IDI (~1.7%) 和NRI (~17%).
结论:
- 非侵入性测量的SPTI和DPTI是一般人群中心血管事件和中风的有价值的独立预测指标.
- 在这一群体中,SEVR似乎没有促进心血管风险分层.
- 这些发现支持将SPTI和DPTI整合到心血管风险评估工具中.
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