Koudsi Abir, Oldroyd John, McElduff Patrick, Banerjee Moulinath, Vyas Avni, Cruickshank J Kennedy
Clinical Epidemiology and Cardiovascular Medicine Group, Division of Cardiovascular and Endocrine Sciences, University Department of Medicine, Manchester Royal Infirmary, Manchester, United Kingdom.
Hypertension. 2007 Jan;49(1):225-31. doi: 10.1161/01.HYP.0000250434.73119.7a. Epub 2006 Nov 6.
Aortic pulse wave velocity (aPWV), a noninvasive measure of vascular stiffness, is an independent predictor of cardiovascular disease both before and in overt vascular disease. Its characteristics in early life and its relationship to maternal factors have hardly been studied. To test the hypothesis that infant aPWV was positively related to maternal anthropometry and blood pressure (BP) at 28 weeks gestation, after adjusting for neonatal anthropometry and BP, 148 babies born in Manchester were measured 1 to 3 days after birth. A high reproducibility of aPWV, assessed in 30 babies within 3 days of birth, was found with a mean difference between occasions of -0.04 m/s (95% CI: -0.08 to 0.16 m/s). Contrary to our hypothesis, a significant inverse relation was found between neonatal aPWV (mean: 4.6 m/s) and maternal systolic BP (mean: 108.9 mm Hg; r=-0.57; 95% CI: -0.67 to -0.45) but not maternal height nor weight. Neonatal aPWV was positively correlated with birth length, birth weight, and systolic BP. In multiple regression, neonatal aPWV remained significantly inversely associated with maternal systolic BP (adjusted beta coefficient: -0.032; 95% CI: -0.040 to -0.024; P<0.001), after adjustment for maternal age, birth weight, length, and neonatal BP (all independently and positively related to aPWV) and for gestational age, maternal weight, and height (unrelated). These results suggest that infant aPWV may be a useful index of infant vascular status, is less disturbing to measure than infant BP, and is sensitive to the gestational environment marked by maternal BP.
主动脉脉搏波速度(aPWV)是一种评估血管僵硬度的非侵入性指标,无论是在明显的血管疾病发生之前还是之后,都是心血管疾病的独立预测因子。其在生命早期的特征及其与母体因素的关系几乎未被研究过。为了验证婴儿aPWV与孕28周时母体人体测量指标及血压(BP)呈正相关这一假设,在对新生儿人体测量指标及血压进行校正后,对曼彻斯特出生的148名婴儿在出生后1至3天进行了测量。在出生后3天内对30名婴儿进行评估,发现aPWV具有较高的重复性,两次测量之间的平均差异为-0.04米/秒(95%CI:-0.08至0.16米/秒)。与我们的假设相反,发现新生儿aPWV(平均:4.6米/秒)与母体收缩压(平均:108.9毫米汞柱;r=-0.57;95%CI:-0.67至-0.45)之间存在显著的负相关关系,而与母体身高和体重无关。新生儿aPWV与出生身长、出生体重及收缩压呈正相关。在多元回归分析中,在对母体年龄、出生体重、身长、新生儿血压(均独立且与aPWV呈正相关)以及胎龄、母体体重和身高(无关)进行校正后,新生儿aPWV仍与母体收缩压呈显著负相关(校正后的β系数:-0.032;95%CI:-0.040至-0.024;P<0.001)。这些结果表明,婴儿aPWV可能是评估婴儿血管状态的有用指标,比婴儿血压测量更不易受干扰,并且对以母体血压为特征的妊娠环境敏感。