Haiden Mio, Kimura Yutaka, Miyasaka Yoko, Aota Yasuko, Dote Kinuko, Takada Atsuaki, Iwasaka Toshiji
Cardiovascular Division, Department of Medicine II, Kansai Medical University, Osaka, Japan.
Acta Cardiol. 2008 Oct;63(5):603-8. doi: 10.2143/AC.63.5.2033228.
Although brachial-ankle pulse wave velocity is a widely used index of arterial stiffness, there are several limitations of this method. The actual length of an artery used for measuring pulse wave velocity is estimated based on an anatomical correction value, and brachial-ankle pulse wave velocity is directly affected by systemic blood pressure or vascular occlusion. Thus, the aim of this study was to determine whether aortic wall strain rate as measured by tissue Doppler imaging is a more useful modality for evaluating regional arterial stiffness than brachial-ankle pulse wave velocity.
Seventy-two patients (18 to 78 years) with normal cardiac function and without large vessel complications were enrolled in this study.
A significant positive correlation was found between brachial-ankle pulse wave velocity and age, and brachial-ankle pulse wave velocity increased with age (r = 0.64, P < 0.0001).A significant negative correlation was found between strain rate and age, and strain rate decreased with age (r = -0.44, P < 0.05). A significant correlation was also found between brachial-ankle pulse wave velocity and systolic blood pressure (r = 0.45, P < 0.02), but not between strain rate and systolic blood pressure.There was no significant difference in brachial-ankle pulse wave velocity between hyperlipidaemic and normolipidaemic subjects. However, strain rate was lower in hyperlipidaemic than in normolipidaemic subjects (P < 0.05).
Strain rate on the ascending aortic wall is a novel and more accurate index of regional arterial stiffness than brachial-ankle pulse wave velocity.
尽管肱踝脉搏波速度是一种广泛应用的动脉僵硬度指标，但该方法存在若干局限性。用于测量脉搏波速度的动脉实际长度是根据解剖校正值估算的，肱踝脉搏波速度直接受全身血压或血管闭塞的影响。因此，本研究的目的是确定组织多普勒成像测量的主动脉壁应变率是否比肱踝脉搏波速度更有助于评估局部动脉僵硬度。
本研究纳入了72例心功能正常且无大血管并发症的患者（年龄18至78岁）。
肱踝脉搏波速度与年龄之间存在显著正相关，且肱踝脉搏波速度随年龄增长而增加（r = 0.64，P < 0.0001）。应变率与年龄之间存在显著负相关，且应变率随年龄增长而降低（r = -0.44，P < 0.05）。肱踝脉搏波速度与收缩压之间也存在显著相关性（r = 0.45，P < 0.02），但应变率与收缩压之间无显著相关性。高脂血症患者与血脂正常患者的肱踝脉搏波速度无显著差异。然而，高脂血症患者的应变率低于血脂正常患者（P < 0.05）。
升主动脉壁应变率是一种比肱踝脉搏波速度更新颖、更准确的局部动脉僵硬度指标。
