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5分钟前臂压迫后1分钟肱动脉搏动指数变化:与血流介导的血管舒张的比较

Brachial artery pulsatility index change 1 minute after 5-minute forearm compression: comparison with flow-mediated dilatation.

作者信息

Martins Wellington P, Nastri Carolina O, Ferriani Rui A, Filho Francisco Mauad

机构信息

Departamento de Ginecologia e Obstetrícia, Faculdade de Medicina de Ribeirão Preto, Universidade de São Paulo, Ribeirão Preto, 14049-900 São Paulo-SP, Brazil.

出版信息

J Ultrasound Med. 2008 May;27(5):693-9. doi: 10.7863/jum.2008.27.5.693.

Abstract

OBJECTIVE

Endothelial impairment evaluation by sonographic measurement of flow-mediated dilatation (FMD) has become broadly used. However, this method has 2 main caveats: the dilatation depends on the baseline arterial diameter, and a high precision level is required. Vasodilatation leads to an amplified fall in impedance. We hypothesized that assessment of the pulsatility index change (PI-C) 1 minute after 5-minute forearm compression might evaluate that fall in impedance. The aim of this study was to compare the PI-C with FMD.

METHODS

Flow-mediated dilatation and the PI-C were assessed in 51 healthy women aged between 35.1 and 67.1 years. We correlated both FMD and the PI-C with age, body mass index, waist circumference, cholesterol level, high-density lipoprotein level, glucose level, systolic and diastolic blood pressure, pulse pressure, brachial artery diameter, simplified Framingham score, intima-media thickness, and carotid stiffness index. Intraclass correlation coefficients between 2 FMD and PI-C measurements were also examined.

RESULTS

Only FMD correlated with baseline brachial diameter (r = -0.53). The PI-C had a high correlation with age, body mass index, waist circumference, cholesterol level, systolic blood pressure, pulse pressure, simplified Framingham score, and intima-media thickness. The correlation between FMD and the PI-C was high (r = -0.66). The PI-C had a higher intraclass correlation coefficient (0.991) than FMD (0.836) but not brachial artery diameter (0.989).

CONCLUSIONS

The PI-C had a large correlation with various markers of cardiovascular risk. Additionally, PI-C measurement does not require offline analysis, extra software, or electrocardiography. We think that the PI-C could be considered a marker of endothelial function. However, more studies are required before further conclusions.

摘要

目的

通过超声测量血流介导的血管舒张功能(FMD)来评估内皮功能障碍已被广泛应用。然而,该方法有两个主要问题:血管舒张取决于基线动脉直径,且需要高精度水平。血管舒张会导致阻抗的放大下降。我们假设,在对前臂进行5分钟压迫后1分钟评估搏动指数变化(PI-C)可能会评估该阻抗下降情况。本研究的目的是比较PI-C与FMD。

方法

对51名年龄在35.1至67.1岁之间的健康女性进行血流介导的血管舒张功能和PI-C评估。我们将FMD和PI-C与年龄、体重指数、腰围、胆固醇水平、高密度脂蛋白水平、血糖水平、收缩压和舒张压、脉压、肱动脉直径、简化的弗雷明汉评分、内膜中层厚度和颈动脉僵硬度指数进行了相关性分析。还检查了两次FMD和PI-C测量之间的组内相关系数。

结果

只有FMD与基线肱动脉直径相关(r = -0.53)。PI-C与年龄、体重指数、腰围、胆固醇水平、收缩压、脉压、简化的弗雷明汉评分和内膜中层厚度高度相关。FMD与PI-C之间的相关性较高(r = -0.66)。PI-C的组内相关系数(0.991)高于FMD(0.836),但低于肱动脉直径(0.989)。

结论

PI-C与多种心血管风险标志物有很大相关性。此外,PI-C测量不需要离线分析、额外软件或心电图检查。我们认为PI-C可被视为内皮功能的标志物。然而,在得出进一步结论之前还需要更多研究。

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