Podolec Piotr, Kopeć Grzegorz, Podolec Jakub, Wilkołek Piotr, Krochin Marek, Rubiś Paweł, Cwynar Marcin, Grodzicki Tomasz, Zmudka Krzysztof, Tracz Wiesława
Department of Cardiac and Vascular Diseases, Jagiellonian University, Collegium Medicum, Kraków, Poland.
Hypertens Res. 2007 Dec;30(12):1151-8. doi: 10.1291/hypres.30.1151.
The objectives of this study were to determine the relationship between carotid-femoral (cfPWV) and aortic pulse wave velocity (aPWV) and to compare their modulators and association with coronary artery disease (CAD). We studied 107 consecutive patients (68 men) with a mean age of 60.49+/-8.31 years who had stable angina and had been referred for coronary angiography. cfPWV and aPWV were measured simultaneously during cardiac catheterization using the Complior device and aortic pressure waveform recordings, respectively. Based on the presence or absence of significant coronary artery stenosis (CAS) patients were subdivided into a CAS+ or CAS- group. The mean values of cfPWV and aPWV were 10.65+/-2.29 m/s and 8.78+/-2.24 m/s, respectively. They were significantly higher in the CAS+ (n=71) compared with the CAS- (n=36) group and predicted significant CAS independently of cardiovascular risk factors and mean or systolic aortic blood pressure. aPWV and cfPWV were significantly correlated (r=0.70; p<0.001) but the degree of correlation differed significantly (p<0.03) between the CAS+ (r=0.74, p<0.001) and CAS- group (r=0.46, p=0.003). Age and mean aortic blood pressure were independent predictors for aPWV as well as cfPWV. In the receiver operating characteristic (ROC) analysis, aPWV and cfPWV had similar accuracy in identification of significant CAS (AUC [area under the ROC curve]=0.76 and 0.69, respectively; p=0.13). However, neither cfPWV nor aPWV was effective at differentiating the extent of CAD. In conclusion, aPWV and cfPWV are highly correlated parameters with similar determinants and comparable accuracy in predicting significant CAS. The strength of correlation between these two indices differed significantly between subjects with and those without CAS.
本研究的目的是确定颈动脉 - 股动脉脉搏波速度(cfPWV)与主动脉脉搏波速度(aPWV)之间的关系,并比较它们的调节因素以及与冠状动脉疾病(CAD)的关联。我们研究了107例连续的患者(68例男性),平均年龄为60.49±8.31岁,这些患者患有稳定型心绞痛并被转诊进行冠状动脉造影。在心脏导管插入术期间,分别使用Complior设备和主动脉压力波形记录同时测量cfPWV和aPWV。根据是否存在显著冠状动脉狭窄(CAS),将患者分为CAS +组或CAS -组。cfPWV和aPWV的平均值分别为10.65±2.29 m/s和8.78±2.24 m/s。与CAS -组(n = 36)相比,CAS +组(n = 71)中的这些值显著更高,并且独立于心血管危险因素以及平均或收缩期主动脉血压预测显著的CAS。aPWV和cfPWV显著相关(r = 0.70;p <0.001),但CAS +组(r = 0.74,p <0.001)和CAS -组(r = 0.46,p = 0.003)之间的相关程度差异显著(p <0.03)。年龄和平均主动脉血压是aPWV以及cfPWV的独立预测因素。在受试者工作特征(ROC)分析中,aPWV和cfPWV在识别显著CAS方面具有相似的准确性(ROC曲线下面积[AUC]分别为0.76和0.69;p = 0.13)。然而,cfPWV和aPWV在区分CAD的程度方面均无效。总之,aPWV和cfPWV是高度相关的参数,在预测显著CAS方面具有相似的决定因素和可比的准确性。这两个指标之间的相关强度在有和没有CAS的受试者之间差异显著。