动脉系统中的反射与冠心病风险

Reflection in the arterial system and the risk of coronary heart disease.

作者信息

Hayashi Tomoshige, Nakayama Yasunori, Tsumura Kei, Yoshimaru Kiyomichi, Ueda Hiroyasu

机构信息

Department of Cardiology, Ishikiriseiki Hospital, Higashiosaka-City, Osaka, Japan.

出版信息

Am J Hypertens. 2002 May;15(5):405-9. doi: 10.1016/s0895-7061(02)02260-4.

DOI:10.1016/s0895-7061(02)02260-4

PMID:12022242

Abstract

BACKGROUND

Although it was reported that the augmentation index and inflection time are closely related to reflection in the arterial system and large artery function, it is not known whether these indices of the ascending aortic pressure waveform increase the risk of coronary heart disease (CHD). The purpose of this study was to evaluate whether the aortic reflection of the ascending aortic pressure waveform is related to an increased risk of CHD.

METHODS

We enrolled 190 men and women who had chest pain, normal contractions, no local asynergy, and no history of myocardial infarction. We measured the ascending aortic pressure using a fluid-filled system. The inflection time was defined as the time interval from initiation of a systolic pressure waveform to the inflection point. We investigated the association between the inflection time and augmentation index of the ascending aorta and the risk of CHD.

RESULTS

Both the inflection time and augmentation index were associated with an increased risk of CHD. The crude prevalence rates of CHD were 66.0% for the shortest quartile and 10.6% for the longest quartile of the inflection time, and 17.0% for the lowest quartile and 40.4% for the highest quartile of the augmentation index. The multiple-adjusted odds ratio of CHD was 30.8 (95% confidence interval [CI] 7.43-128.05) for the shortest quartile of the inflection time compared with the longest quartile and was 3.82 (95% CI 1.26-11.59) for the highest quartile of the augmentation index compared with the lowest quartile.

CONCLUSIONS

The augmentation index and inflection time were associated with an increased risk of CHD.

摘要

背景

尽管有报道称增强指数和转折时间与动脉系统反射及大动脉功能密切相关，但尚不清楚升主动脉压力波形的这些指数是否会增加冠心病（CHD）风险。本研究的目的是评估升主动脉压力波形的主动脉反射是否与冠心病风险增加相关。

方法

我们纳入了190名有胸痛、收缩正常、无局部协同失调且无心肌梗死病史的男性和女性。我们使用充液系统测量升主动脉压力。转折时间定义为从收缩压波形起始到转折点的时间间隔。我们研究了升主动脉的转折时间和增强指数与冠心病风险之间的关联。

结果

转折时间和增强指数均与冠心病风险增加相关。转折时间最短四分位数组的冠心病粗患病率为66.0%，最长四分位数组为10.6%；增强指数最低四分位数组为17.0%，最高四分位数组为40.4%。与最长四分位数相比，转折时间最短四分位数组冠心病的多因素调整比值比为30.8（95%置信区间[CI] 7.43 - 128.05）；与最低四分位数相比，增强指数最高四分位数组冠心病的多因素调整比值比为3.82（95% CI 1.26 - 11.59）。