Fagard R H, Pardaens K, Staessen J A, Thijs L
Department of Molecular and Cardiovascular Research, Faculty of Medicine, University of Leuven, KU Leuven, Belgium.
J Am Coll Cardiol. 2001 Jul;38(1):227-31. doi: 10.1016/s0735-1097(01)01362-6.
The goal of this study was to assess the prognostic power of the pulse pressure-to-stroke index (PP-to-SVi) ratio for cardiovascular events and mortality in patients with uncomplicated hypertension.
The prognostic significance of pulse pressure (PP) has been studied repeatedly, but few data are available on the PP-to-SVi ratio.
Invasive hemodynamic measurements, including brachial intra-arterial pressure and stroke index by the direct oxygen Fick method, were performed in the period 1972 to 1982 in 192 patients with uncomplicated hypertension; their outcome was ascertained in 1994.
Age at baseline averaged 37 +/- 12 years; brachial artery pressure was 165 mm Hg +/- 30/89 +/- 17 mm Hg; PP averaged 76 mm Hg +/- 18 mm Hg, and the PP-to-SVi ratio was 1.67 mm Hg/(ml/m2) +/- 0.73 mm Hg/(ml/m2). During 3,057 patient years of follow-up, 19 patients died, and 44 experienced at least one fatal or nonfatal cardiovascular event. Cox regression analysis revealed that the PP-to-SVi ratio was a significant predictor of fatal and nonfatal cardiovascular events and of all-cause mortality after control for age and gender (p < 0.01). Its predictive power persisted after additional adjustment for mean arterial pressure and heart rate. Each 0.75-mm Hg/(ml/m2) increase in the PP-to-SVi ratio was independently associated with a 79% increase in the risk of a cardiovascular event (p = 0.01) and a 2.05-fold greater risk of all-cause mortality (p = 0.01).
The PP-to-SVi ratio is a significant and independent predictor of cardiovascular events and mortality in selected patients with uncomplicated hypertension.
本研究旨在评估脉压与每搏量指数（PP-to-SVi）比值对单纯性高血压患者心血管事件及死亡率的预后预测能力。
脉压（PP）的预后意义已被反复研究，但关于PP-to-SVi比值的数据较少。
1972年至1982年期间，对192例单纯性高血压患者进行了有创血流动力学测量，包括肱动脉内压和采用直接氧耗量法测定的每搏量指数；1994年确定了他们的预后情况。
基线时平均年龄为37±12岁；肱动脉压为165 mmHg±30/89±17 mmHg；平均脉压为76 mmHg±18 mmHg，PP-to-SVi比值为1.67 mmHg/(ml/m2)±0.73 mmHg/(ml/m2)。在3057患者年的随访期间，19例患者死亡，44例经历了至少一次致命或非致命心血管事件。Cox回归分析显示，在控制年龄和性别后，PP-to-SVi比值是致命和非致命心血管事件以及全因死亡率的显著预测指标（p<0.01）。在进一步调整平均动脉压和心率后，其预测能力依然存在。PP-to-SVi比值每增加0.75 mmHg/(ml/m2)，心血管事件风险独立增加79%（p=0.01），全因死亡率风险增加2.05倍（p=0.01）。
PP-to-SVi比值是特定单纯性高血压患者心血管事件及死亡率的显著且独立的预测指标。
