Yamashina Akira, Tomiyama Hirofumi
Second Department of Internal Medicine, Tokyo Medical University.
Nihon Rinsho. 2004 Jan;62(1):80-6.
Impairment of the arterial compliance or loss of Windkessel effect of elastic arteries causes increased afterload to the heart and increased pulsatile flow to the peripheral vasculatures. The former induces left ventricular hypertrophy or dysfunction and the latter induces small vessel damage or end organ dysfunction. Thus, the arterial compliance plays important roles in the course of hypertension. Therefore; it is worthwhile to measure the elastic properties of aortoarterial system in patient with hypertension. The velocity of the pressure wave along an arterial system, known as pulse wave velocity(PWV), is related to the average stiffness of an arterial segment between measurement sites. The measurement of PWV is inversely related to arterial wall distensibility, which offers a simple and potential approach. There are numerous reports which PWV is a forceful marker and predictor of the cardiovascular risk in hypertensive or other arteriosclerotic disorders. Thus, PWV measurement is recommended in patients with hypertension for early detection of organ damages or estimation of the cardiovascular risk, as well as for the evaluation of the effectiveness of the treatment as a surrogate marker.
弹性动脉的动脉顺应性受损或弹性贮器作用丧失会导致心脏后负荷增加以及外周血管系统的搏动性血流增加。前者会诱发左心室肥厚或功能障碍，后者会诱发小血管损伤或终末器官功能障碍。因此，动脉顺应性在高血压病程中起着重要作用。所以，测量高血压患者主动脉动脉系统的弹性特性是值得的。沿动脉系统的压力波速度，即脉搏波速度（PWV），与测量部位之间动脉节段的平均硬度有关。PWV的测量与动脉壁的扩张性呈负相关，这提供了一种简单且有潜力的方法。有大量报告表明，PWV是高血压或其他动脉硬化疾病中心血管风险的有力标志物和预测指标。因此，建议对高血压患者进行PWV测量，以便早期发现器官损害或评估心血管风险，以及作为替代标志物评估治疗效果。
