Duprez Daniel A, Cohn Jay N
Cardiovascular Division, Rasmussen Center for Cardiovascular Disease Prevention, University of Minnesota Medical School, 420 Delaware Street SE, Minneapolis, MN 55455, USA.
J Clin Hypertens (Greenwich). 2008 Mar;10(3):226-31. doi: 10.1111/j.1751-7176.2008.07429.x.
Most attempts to identify individuals at risk for cardiovascular morbid events have involved screening for risk factors. These traditional risk factors do not identify the underlying atherosclerotic disease nor assess the severity of disease in individual patients. The goal for identifying a marker or markers for early cardiovascular disease that could serve as a surrogate for disease progression and ultimate morbid events is to improve the precision for early detection and treatment. The authors utilize a variety of techniques, which consist of 7 vascular tests (large and small artery elasticity, resting blood pressure and exercise blood pressure response, optic fundus photography, carotid intimal-media thickness, and microalbuminuria) and 3 cardiac tests (electrocardiography, [N-terminal pro-] B-type natriuretic peptide, and left ventricular ultrasonography). Each test is individually scored, and the total disease score is the sum of all the test scores. A study is ongoing to compare the new disease score vs the classical Framingham risk estimate in the prediction of cardiovascular events.
大多数识别心血管疾病不良事件风险个体的尝试都涉及对风险因素进行筛查。这些传统风险因素既无法识别潜在的动脉粥样硬化疾病，也无法评估个体患者的疾病严重程度。识别早期心血管疾病标志物的目标是提高早期检测和治疗的精准度，这些标志物可作为疾病进展和最终不良事件的替代指标。作者采用了多种技术，包括7项血管检查（大动脉和小动脉弹性、静息血压和运动血压反应、眼底摄影、颈动脉内膜中层厚度以及微量白蛋白尿）和3项心脏检查（心电图、[N端前体-]B型利钠肽以及左心室超声检查）。每项检查单独计分，总疾病得分是所有检查得分之和。一项正在进行的研究旨在比较新的疾病得分与经典的弗雷明汉姆风险评估在预测心血管事件方面的差异。
