动脉波反射增强可能易引发晕厥发作。
Increased arterial wave reflection may predispose syncopal attacks.
作者信息
Chen C H, Hu H H, Lin Y P, Chern C M, Hsu T L, Ding P Y
机构信息
Department of Medicine and Center of Neuroscience, Taipei Veterans General Hospital, Taiwan.
出版信息
Clin Cardiol. 2000 Nov;23(11):825-30. doi: 10.1002/clc.4960231108.
BACKGROUND
The incidence of syncope increases with age, while aging is also associated with increased arterial wave reflection.
HYPOTHESIS
The study was undertaken to determine whether increased arterial wave reflection is a predisposing factor of syncope.
METHODS
We recruited 38 patients (28 men and 10 women, mean age 57.2 +/- 20.3 years, range 17-87 years) with a history of syncope within 6 months of entry. The etiology of syncope was documented for each patient by a complete assessment of vasomotor function and cerebral flow. All patients received a comprehensive echocardiographic evaluation of cardiac structure and function. Carotid augmentation index (AI) was estimated noninvasively with the tonometry technique. The results were compared with those from 54 age- and gender-matched controls.
RESULTS
The most frequent diagnoses of syncope were postural hypotension (13 patients) and cerebrovascular dysautoregulation (10 patients), and the cause could not be determined in 9 patients. Compared with the control group, the syncope group had a greater AI (20 +/- 21 vs. 10 +/- 15%, p = 0.013). Subgroup analysis of 20 patients aged > 50 years and with the aforementioned diagnoses showed even more striking results: AI, 29 +/- 10 vs. 11 +/- 15%, p < 0.001. The enhanced augmentation in the patients remained when age, systolic blood pressure, height, and heart rate were accounted for. Analysis of the carotid pulse wave suggested that both the timing and intensity of wave reflection were enhanced in patients with a history of syncope compared with controls.
CONCLUSIONS
Our results support the hypothesis that enhanced arterial wave reflection is associated with the occurrence of syncope, especially in the elderly.
背景
晕厥的发生率随年龄增长而增加，而衰老也与动脉波反射增加有关。
假设
本研究旨在确定动脉波反射增加是否是晕厥的一个诱发因素。
方法
我们招募了38例患者（28例男性和10例女性，平均年龄57.2±20.3岁，范围17 - 87岁），这些患者在入组前6个月内有晕厥病史。通过对血管运动功能和脑血流进行全面评估，记录每位患者晕厥的病因。所有患者均接受了关于心脏结构和功能的全面超声心动图评估。采用眼压测量技术无创估计颈动脉增强指数（AI）。将结果与54例年龄和性别匹配的对照组进行比较。
结果
晕厥最常见的诊断为体位性低血压（13例患者）和脑血管调节异常（10例患者），9例患者病因不明。与对照组相比，晕厥组的AI更高（20±21 vs. 10±15%，p = 0.013）。对20例年龄>50岁且有上述诊断的患者进行亚组分析显示结果更为显著：AI为29±10 vs. 11±15%，p < 0.001。在考虑年龄、收缩压、身高和心率后，患者的增强增强情况仍然存在。对颈动脉脉搏波的分析表明，与对照组相比，有晕厥病史的患者波反射的时间和强度均增强。
结论
我们的结果支持以下假设，即动脉波反射增强与晕厥的发生有关，尤其是在老年人中。
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