Millasseau Sandrine C, Kelly Ronan P, Ritter James M, Chowienczyk Philip J
Department of Clinical Pharmacology, St. Thomas' Hospital, Centre for Cardiovascular Biology and Medicine, King's College, London, United Kingdom.
Am J Hypertens. 2003 Jun;16(6):467-72. doi: 10.1016/s0895-7061(03)00569-7.
Indices of pressure wave reflection (RI(DVP)) and large artery stiffness (SI(DVP)) can be derived from the digital volume pulse (DVP). Indices obtained from the second derivative of the DVP have also been proposed to characterize vascular aging and effects of vasoactive drugs.
We compared RI(DVP) and SI(DVP) with the indices a/b, a/c, a/d, and a/e calculated from sequential peaks of the second derivative of the DVP in 124 healthy men. The DVP was obtained by measuring infrared light transmission through the finger. In 10 men measurements were obtained at baseline and during intravenous infusion of glyceryl trinitrate (GTN, 3 to 300 microg/min) and, on separate occasions, angiotensin II (AII, 75 to 300 microg/min) and saline vehicle.
SI(DVP) was strongly associated with age (R = 0.63, P <.001) but little influenced by AII or GTN. RI(DVP) was weakly associated with age but showed a consistent dose-dependent increase during AII and a decrease during GTN. d/a was strongly associated with age (R = -0.66, P <.001), influenced by vasoactive drugs but did not change in a dose-dependent manner during GTN. Other second derivative indices were less strongly correlated with age and showed an inconsistent response to vasoactive drugs. Within subject standard deviations of SI(DVP) and d/a for measurements on different occasions were 2.1 and 5.4 "years of vascular aging" respectively.
In healthy men, RI(DVP) may be a more reliable index of the effects of vasoactive drugs than d/a. SI(DVP) is similarly associated with age as is d/a, but less variable and may thus be a better index of vascular aging.
压力波反射指数(RI(DVP))和大动脉僵硬度指数(SI(DVP))可从数字容积脉搏(DVP)中得出。也有人提出,从DVP的二阶导数获得的指数可用于表征血管老化及血管活性药物的作用。
我们将RI(DVP)和SI(DVP)与从124名健康男性DVP二阶导数的连续峰值计算得出的a/b、a/c、a/d和a/e指数进行了比较。DVP通过测量透过手指的红外光传输获得。在10名男性中,于基线以及静脉输注硝酸甘油(GTN,3至300微克/分钟)期间进行测量,并且在不同时间分别输注血管紧张素II(AII,75至300微克/分钟)和生理盐水。
SI(DVP)与年龄密切相关(R = 0.63,P <.001),但受AII或GTN的影响较小。RI(DVP)与年龄的相关性较弱,但在输注AII期间呈一致的剂量依赖性增加,在输注GTN期间则降低。d/a与年龄密切相关(R = -0.66,P <.001),受血管活性药物影响,但在输注GTN期间未呈剂量依赖性变化。其他二阶导数指数与年龄的相关性较弱,并且对血管活性药物的反应不一致。不同时间测量的SI(DVP)和d/a的受试者内标准差分别为2.1和5.4“血管老化年数”。
在健康男性中,RI(DVP)可能是比d/a更可靠的血管活性药物作用指标。SI(DVP)与年龄的相关性与d/a相似,但变异性较小,因此可能是更好的血管老化指标。