Urbina Elaine M, Brinton Todd J, Elkasabany Abdalla, Berenson Gerald S
Tulane University Medical Center, Section of Pediatric Cardiology, New Orleans, Louisiana 70112-7103, USA.
Am J Cardiol. 2002 Apr 15;89(8):946-51. doi: 10.1016/s0002-9149(02)02244-0.
Arterial distensibility decreases with age and atherosclerosis leading to increased pulse pressure (PP) and increased left ventricular work, resulting in left ventricular hypertrophy, a risk factor for cardiovascular morbidity. Brachial artery pulse curve data were collected using the DynaPulse 2000A. Distensibility measured in 920 healthy young adults (40% men, 70% white, age range 18 to 38 years) was compared with levels of cardiovascular risk factors. Laboratory, anthropometric, blood pressure (BP), and heart rate measurements were also obtained. Distensibility tended to decrease with age, reaching significance in women (p <0.05). Whites had greater distensibility adjusted for age than blacks, with women more than men (p <0.05). Distensibility adjusted for PP was negatively correlated with measures of body size, BP, glucose, insulin, low-density lipoprotein cholesterol, very low density lipoprotein cholesterol, and age (p <0.05). When distensibility was plotted as a function of PP to control for distending pressure, the lowest quintiles of systolic, diastolic, and mean arterial BPs tended to have greater distensibility. No differences were seen by quintiles of lipids. In multivariate analyses, BP, age, anthropometric measures, gender, and very low density lipoprotein cholesterol entered the model (r(2) = 0.56; p <0.02). Thus, brachial artery distensibility, which includes a normalization factor to control for body size, showed race and gender differences (whites and women had greater distensibility than blacks and men, respectively), even after adjustment for age. Stiffer vessels with decreased distensibility were seen in subjects with higher levels of cardiovascular risk factors across the range of normal PP. Therefore, noninvasive measures of distensibility are useful in measuring subclinical vascular changes related to arteriosclerosis.
动脉扩张性随年龄增长和动脉粥样硬化而降低，导致脉压（PP）增加和左心室做功增加，进而导致左心室肥厚，这是心血管疾病发病的一个危险因素。使用DynaPulse 2000A收集肱动脉脉搏曲线数据。将920名健康年轻人（40%为男性，70%为白人，年龄范围为18至38岁）的扩张性测量值与心血管危险因素水平进行比较。还获取了实验室检查、人体测量、血压（BP）和心率测量值。扩张性倾向于随年龄降低，在女性中达到显著水平（p<0.05）。调整年龄后，白人的扩张性高于黑人，女性高于男性（p<0.05）。调整PP后的扩张性与体型、BP、血糖、胰岛素、低密度脂蛋白胆固醇、极低密度脂蛋白胆固醇和年龄的测量值呈负相关（p<0.05）。当将扩张性绘制为PP的函数以控制扩张压力时，收缩压、舒张压和平均动脉压最低的五分位数往往具有更大的扩张性。脂质五分位数未见差异。在多变量分析中，BP、年龄、人体测量指标、性别和极低密度脂蛋白胆固醇进入模型（r(2)=0.56；p<0.02）。因此，包括控制体型的标准化因子的肱动脉扩张性即使在调整年龄后仍显示出种族和性别差异（白人女性的扩张性分别高于黑人男性）。在正常PP范围内，心血管危险因素水平较高的受试者血管更僵硬，扩张性降低。因此，扩张性的非侵入性测量有助于测量与动脉硬化相关的亚临床血管变化。
