Kwater Aleksander, Gasowski Jerzy, Gryglewska Barbara, Wizner Barbara, Grodzicki Tomasz
Department of Internal Medicine and Gerontology, Jagiellonian University, Kraków, Poland.
Blood Press. 2009;18(3):130-4. doi: 10.1080/08037050902975114.
The relationship between systemic arterial stiffness and parameters of cerebral circulation is poorly understood. We aimed to assess the relation between pulsatility (PI) and resistance (RI) indexes of the middle cerebral artery (MCA) and aortic pulse wave velocity (PWV) and brachial pulse pressure (PP).
Bilateral transcranial Doppler ultrasound (TCD) examination of the MCAs was performed using the GE Vivid 3 Ultrasound, equipped with a 2.5-MHz probe and PI and RI were calculated. Aortic PWV was obtained with the Complior device (Colson France). Conventional blood pressures were measured at the time of TCD. Data regarding risk-profile constituents, habits and medication use were recorded. Subjects with occlusion or significant stenosis of carotid arteries or MCA, previous or acute stroke, temporary ischaemic attack, bilaterally absent transtemporal sonographic windows, dysrhythmia, haematocrit value <30% or >48% were excluded.
Of the 165 included subjects (mean age, 56.70+/-11.80 years, range 22-86 years), 50.3% were men, 20.9% smokers, 20.7% diabetic and 63.4% hypertensive. PWV correlated to both PI (r=0.45, p<0.001) and RI (r=0.36, p<0.001) of MCA. A similar relation was found for PP and PI (r=0.32, p<0.001) or RI (r=0.30, p<0.001). Age, diabetes and hypertension, but not chronic tobacco smoking, interfered with MCA flow parameters. In multivariate adjusted regression analysis, PP was related to both PI and RI of MCA (p<0.001). In similar models, increased PWV was related to PI (p=0.007), but not RI (p=0.08) of MCA.
Increased PI and RI of MCA are closely related to measures of increased aortic stiffness.
全身动脉僵硬度与脑循环参数之间的关系尚不清楚。我们旨在评估大脑中动脉（MCA）的搏动指数（PI）和阻力指数（RI）与主动脉脉搏波速度（PWV）和肱动脉脉压（PP）之间的关系。
使用配备2.5MHz探头的GE Vivid 3超声对双侧MCA进行经颅多普勒超声（TCD）检查，并计算PI和RI。使用Complior设备（法国科尔森公司）获取主动脉PWV。在进行TCD检查时测量常规血压。记录有关风险特征成分、习惯和药物使用的数据。排除患有颈动脉或MCA闭塞或严重狭窄、既往或急性中风、短暂性脑缺血发作、双侧颞部超声窗缺失、心律失常、血细胞比容值<30%或>48%的受试者。
在纳入的165名受试者中（平均年龄56.70±11.80岁，范围22 - 86岁），50.3%为男性，20.9%吸烟，20.7%患有糖尿病，63.4%患有高血压。PWV与MCA的PI（r = 0.45，p < 0.001）和RI（r = 0.36，p < 0.001）均相关。PP与PI（r = 0.32，p < 0.001）或RI（r = 0.30，p < 0.001）之间也发现了类似的关系。年龄、糖尿病和高血压会干扰MCA血流参数，但长期吸烟不会。在多变量调整回归分析中，PP与MCA的PI和RI均相关（p < 0.001）。在类似模型中，PWV升高与MCA的PI相关（p = 0.007），但与RI无关（p = 0.08）。
MCA的PI和RI升高与主动脉僵硬度增加的指标密切相关。
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