Soga Junko, Nakamura Shuji, Nishioka Kenji, Umemura Takashi, Jitsuiki Daisuke, Hidaka Takayuki, Teragawa Hiroki, Takemoto Hiroaki, Goto Chikara, Yoshizumi Masao, Chayama Kazuaki, Higashi Yukihito
Department of Medicine and Molecular Science, Hiroshima University Graduate School of Biomedical Sciences, Hiroshima, Japan.
Hypertens Res. 2008 Jul;31(7):1293-8. doi: 10.1291/hypres.31.1293.
Recent studies have shown that the augmentation index (AI) is a predictor of cardiovascular complications. Endothelial dysfunction is the initial step in the pathogenesis of atherosclerosis, which in turn can lead to cardiovascular complications. Endothelial function assessed by flow-mediated dilation (FMD) can serve as an independent predictor of cardiovascular events. However, there is little information on the relationship between AI and FMD in the human vasculature, and we therefore investigated this relationship in the present study. A total of 100 subjects (71 males and 29 females; age range, 22-88 years; mean age, 59 +/- 17 years), including 83 patients with cardiovascular diseases (e.g., atherosclerosis, hypertension, coronary heart disease, stroke and peripheral arterial disease) and 17 healthy subjects were enrolled. High-resolution ultrasonography (automated vessel-diameter measurements; eTRACKING system), a linear array transducer (13 MHz) and an arm holding device were used to measure the arterial diameter response to reactive hyperemia and sublingual nitroglycerine (NTG, 75 micrograms) in all subjects. AI measured using an automated device was significantly correlated with FMD (r = -0.38, p < 0.0001). There was no significant correlation between AI and vascular response to NTG. Multiple regression analysis showed that FMD was a significant independent predictor of AI (p < 0.05). These findings suggest that increase in arterial stiffness may be associated with grade of endothelial dysfunction and that AI may be an index of not only arterial stiffness but also endothelial function.
近期研究表明，增强指数（AI）是心血管并发症的一个预测指标。内皮功能障碍是动脉粥样硬化发病机制的起始步骤，进而可导致心血管并发症。通过血流介导的血管舒张功能（FMD）评估的内皮功能可作为心血管事件的独立预测指标。然而，关于人体血管中AI与FMD之间关系的信息较少，因此我们在本研究中对这种关系进行了调查。总共纳入了100名受试者（71名男性和29名女性；年龄范围22 - 88岁；平均年龄59±17岁），其中包括83例心血管疾病患者（如动脉粥样硬化、高血压、冠心病、中风和外周动脉疾病）以及17名健康受试者。使用高分辨率超声检查（自动测量血管直径；eTRACKING系统）、线性阵列换能器（13 MHz）和手臂固定装置来测量所有受试者对反应性充血和舌下含服硝酸甘油（NTG，75微克）的动脉直径反应。使用自动装置测量的AI与FMD显著相关（r = -0.38，p < 0.0001）。AI与血管对NTG的反应之间无显著相关性。多元回归分析表明，FMD是AI的一个显著独立预测指标（p < 0.05）。这些发现提示，动脉僵硬度增加可能与内皮功能障碍程度相关，并且AI可能不仅是动脉僵硬度的指标，也是内皮功能的指标。
