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纤维蛋白原与动脉僵硬度及波反射的关系。

Relationship of fibrinogen with arterial stiffness and wave reflections.

作者信息

Vlachopoulos Charalambos, Pietri Panagiota, Aznaouridis Konstantinos, Vyssoulis Gregory, Vasiliadou Carmen, Bratsas Athanasios, Tousoulis Dimitris, Xaplanteris Panagiotis, Stefanadi Elli, Stefanadis Christodoulos

机构信息

Hypertension Unit, 1st Department of Cardiology, Athens Medical School, Hippokration Hospital, Athens, Greece.

出版信息

J Hypertens. 2007 Oct;25(10):2110-6. doi: 10.1097/HJH.0b013e3282dc25da.

Abstract

INTRODUCTION

Increased levels of fibrinogen have been related to target organ damage and cardiovascular outcomes. Arterial elastic properties are important determinants of cardiovascular performance and predictors of the corresponding risk. This study investigated whether the fibrinogen level is associated with arterial stiffness and wave reflections.

METHODS

We studied 229 consecutive, non-diabetic patients with uncomplicated, never-treated essential hypertension (mean age 51 years, 149 men) and an age-matched control group of 159 normotensive individuals (mean age 50 years, 83 men). Carotid-femoral and carotid-radial pulse wave velocity (PWVc-f and PWVc-r) were measured as indices of elastic-type, aortic stiffness and muscular type, medium-sized arterial stiffness, respectively. The heart rate-corrected augmentation index (AIx75) was estimated as a composite marker of wave reflections and arterial stiffness. Plasma fibrinogen was measured using immunonephelometry.

RESULTS

The fibrinogen level and arterial function indices (PWVc-f, PWVc-r, AIx75) were significantly higher in hypertensive patients than controls. In the whole population, fibrinogen level correlated with PWVc-f and AIx75 in univariable analysis, but not with PWVc-r. In multivariable analysis, an independent association was established between fibrinogen level and PWVc-f after adjusting for age, sex, mean pressure, heart rate, height, body mass index, smoking status, and total cholesterol. In contrast, no significant relationship was observed between fibrinogen and AIx75 after adjusting for confounders.

CONCLUSION

The plasma fibrinogen level is independently associated with aortic stiffening. This finding underlines the important role of fibrinogen as a marker of arterial damage, and implies a possible contribution of this compound to the pathophysiology of cardiovascular disease.

摘要

引言

纤维蛋白原水平升高与靶器官损害及心血管结局相关。动脉弹性特性是心血管功能的重要决定因素及相应风险的预测指标。本研究调查了纤维蛋白原水平是否与动脉僵硬度和波反射相关。

方法

我们研究了229例连续的、无并发症且未经治疗的原发性高血压非糖尿病患者(平均年龄51岁,男性149例)以及159例年龄匹配的血压正常个体组成的对照组(平均年龄50岁,男性83例)。分别测量颈股动脉和颈桡动脉脉搏波速度(PWVc-f和PWVc-r)作为弹性型主动脉僵硬度和肌肉型中动脉僵硬度的指标。心率校正的增强指数(AIx75)被评估为波反射和动脉僵硬度的综合标志物。采用免疫比浊法测定血浆纤维蛋白原。

结果

高血压患者的纤维蛋白原水平和动脉功能指标(PWVc-f、PWVc-r、AIx75)显著高于对照组。在整个人群中,单变量分析显示纤维蛋白原水平与PWVc-f和AIx75相关,但与PWVc-r无关。多变量分析中,在调整年龄、性别、平均压、心率、身高、体重指数、吸烟状况和总胆固醇后,纤维蛋白原水平与PWVc-f之间建立了独立关联。相反,在调整混杂因素后,未观察到纤维蛋白原与AIx75之间存在显著关系。

结论

血浆纤维蛋白原水平与主动脉僵硬度独立相关。这一发现强调了纤维蛋白原作为动脉损伤标志物的重要作用,并暗示该化合物可能对心血管疾病的病理生理学有贡献。

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