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[两种动脉扩张性指数的比较:柯氏音的时域表现与脉搏波速度。一项多普勒超声心动图和动态血压监测研究]

[Comparison of two indices of arterial distensibility: temporal apparitions of Korotkoff sounds and pulse wave velocy. A Doppler echocardiography and ambulatory blood pressure monitoring study].

作者信息

Abassade P, Baudouy P Y, Gobet L, Lhosmot J P

机构信息

Service de cardiologie, hôpital Saint-Michel, 33, rue Olivier-de-Serres, 75015, Paris.

出版信息

Arch Mal Coeur Vaiss. 2001 Jan;94(1):23-30.

Abstract

Arterial distensibility, one of the factors influencing afterload, plays a role in the development of left ventricular hypertrophy. The QKd, the delay before the perception of the Korotkoff sounds, is an index of arterial distensibility available from ambulatory blood pressure monitoring. The pulse wave velocity (PWV), another index of arterial distensibility, can be measured by Doppler echocardiography. The aim of this study was to compare these two indices with haemodynamic parameters of arterial distensibility and to determine their relationship to left ventricular geometry and function. Sixty-two consecutive patients, with and without cardiac disease, underwent simultaneous Doppler echocardiography and ambulatory blood pressure monitoring. A correlation was observed between QKd and PWV (N = 53, p = 0.007, r = 0.37). The QKd and PWV were correlated to the absolute index of arterial distensibility (systolic index/pulse pressure) (N = 51, p < 0.001, r = 0.48). QKd was correlated with indices of left ventricular function such as EF (N = 55, p < 0.001, r = 0.66) or the systolic pressure/end systolic dimension ratio (N = 54, p < 0.001, r = 0.75). When the ejection time was subtracted from QKd, only the end systolic pressure/end systolic dimension remained significantly correlated (N = 37, p = 0.005, r = 0.40). The authors conclude that PWV and QKd were correlated and were also correlated with indices of arterial distensibility. QKd is a composite index of left ventricular function and arterial distensibility. Doppler echocardiography and ambulatory blood pressure monitoring provide a non-invasive assessment of the aorta/LV couple.

摘要

动脉扩张性是影响后负荷的因素之一,在左心室肥厚的发展过程中起作用。QKd(柯氏音感知前的延迟时间)是一种可从动态血压监测中获得的动脉扩张性指标。脉搏波速度(PWV)是动脉扩张性的另一个指标,可通过多普勒超声心动图测量。本研究的目的是比较这两个指标与动脉扩张性的血流动力学参数,并确定它们与左心室几何形状和功能的关系。62例连续患者,有或无心脏病,同时接受了多普勒超声心动图和动态血压监测。观察到QKd与PWV之间存在相关性(N = 53,p = 0.007,r = 0.37)。QKd和PWV与动脉扩张性的绝对指标(收缩期指标/脉压)相关(N = 51,p < 0.001,r = 0.48)。QKd与左心室功能指标如射血分数(EF)(N = 55,p < 0.001,r = 0.66)或收缩压/收缩末期内径比值(N = 54,p < 0.001,r = 0.75)相关。当从QKd中减去射血时间时,仅收缩末期压力/收缩末期内径仍保持显著相关性(N = 37,p = 0.005,r = 0.40)。作者得出结论,PWV和QKd相关,并且也与动脉扩张性指标相关。QKd是左心室功能和动脉扩张性的综合指标。多普勒超声心动图和动态血压监测提供了对主动脉/左心室耦合的非侵入性评估。

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