Kovaite Milda, Petrulioniene Zaneta, Ryliskyte Ligita, Badariene Jolita, Cypiene Alma, Dzenkeviciūte Vilma, Laucevicius Aleksandras
Center of Cardiology and Angiology, Santariskes Clinics of Vilnius University Hospital, Santariskiu 2, Vilnius, Lithuania.
Medicina (Kaunas). 2007;43(7):529-41.
To investigate the relationship of arterial wall parameters (flow-mediated dilatation of the brachial artery, augmentation index, pulse wave velocity, stiffness index, carotid intima-media thickness) to conventional cardiovascular risk factors and cardiovascular risk assessed by SCORE system.
A total of 209 subjects aged 40-65 years without clinically overt cardiovascular disease were examined. Parameters of arterial stiffness were obtained by two methods: augmentation index and carotid-radial pulse wave velocity by applanation tonometry and stiffness index by the means of finger photoplethysmography. Flow-mediated dilatation of the brachial artery, reflecting endothelial function, and carotid intima-media thickness was determined using a high-resolution B-mode ultrasonography.
Age and the presence of diabetes strongly influenced all parameters of the arterial wall (diabetes was not independent predictor when evaluating augmentation index). Mean arterial pressure and gender were independent predictors for arterial stiffness parameters--carotid-radial pulse wave velocity and augmentation index. Flow-mediated dilatation was strongly dependent on the diameter of the brachial artery, age, and body mass index. Using logistic regression, it was found that pulse wave velocity (P=0.014), intima-media thickness (P=0.004), and flow-mediated dilatation (P=0.020) were important parameters dividing subjects to the groups of increased (> or =5%) and low (<5%) cardiovascular risk assessed by SCORE system. The cutoff values for intima-media thickness and pulse wave velocity were 0.078 cm and 8.95 m/s, respectively.
Arterial wall parameters are closely associated with conventional risk factors; they are influenced by age and the presence of diabetes. Arterial stiffness parameters are also influenced by mean arterial pressure; high-density lipoprotein cholesterol has influence on carotid intima-media thickness. Cutoff values for carotid intima-media thickness and carotid-radial pulse wave velocity could help to discriminate patients with increased cardiovascular risk.
研究动脉壁参数（肱动脉血流介导的扩张、增强指数、脉搏波速度、僵硬度指数、颈动脉内膜中层厚度）与传统心血管危险因素以及通过SCORE系统评估的心血管风险之间的关系。
对总共209名年龄在40 - 65岁且无临床明显心血管疾病的受试者进行检查。通过两种方法获取动脉僵硬度参数：采用压平式眼压计测量增强指数和颈动脉 - 桡动脉脉搏波速度，通过手指光电容积描记法测量僵硬度指数。使用高分辨率B型超声检查来测定反映内皮功能的肱动脉血流介导的扩张以及颈动脉内膜中层厚度。
年龄和糖尿病的存在对动脉壁的所有参数有强烈影响（在评估增强指数时，糖尿病不是独立预测因素）。平均动脉压和性别是动脉僵硬度参数——颈动脉 - 桡动脉脉搏波速度和增强指数的独立预测因素。血流介导的扩张强烈依赖于肱动脉直径、年龄和体重指数。通过逻辑回归发现，脉搏波速度（P = 0.014）、内膜中层厚度（P = 0.004）和血流介导的扩张（P = 0.020）是将受试者分为心血管风险增加（≥5%）和低（<5%）组的重要参数，这是通过SCORE系统评估的。内膜中层厚度和脉搏波速度的临界值分别为0.078厘米和8.95米/秒。
动脉壁参数与传统危险因素密切相关；它们受年龄和糖尿病存在情况的影响。动脉僵硬度参数也受平均动脉压影响；高密度脂蛋白胆固醇对颈动脉内膜中层厚度有影响。颈动脉内膜中层厚度和颈动脉 - 桡动脉脉搏波速度临界值有助于鉴别心血管风险增加的患者。
