Philpott Andrew C, Lonn Eva, Title Lawrence M, Verma Subodh, Buithieu Jean, Charbonneau Francois, Anderson Todd J
Libin Cardiovascular Institute, Department of Cardiac Sciences, University of Calgary, Calgary, Alberta, Canada.
Am J Cardiol. 2009 Jun 1;103(11):1610-5. doi: 10.1016/j.amjcard.2009.01.376. Epub 2009 Apr 8.
Although flow-mediated dilatation (FMD) is widely used, the ideal vascular parameter for the measurement of cardiovascular risk is not clear. Recently, it has been proposed that shear stress and blood velocity during hyperemia (VRH) may provide stronger correlations with cardiovascular risk factors than FMD. The aim of this study was to evaluate the relations of VRH and shear stress during reactive hyperemia (SSRH) to FMD and the association of these measures to cardiovascular risk factors in 1,477 men without cardiovascular disease. SSRH and VRH showed weak correlations with FMD in bivariate analysis (r = 0.239, p <0.001, and r = 0.108, p <0.001, respectively). The only cardiovascular risk factor independently associated with FMD was systolic blood pressure (beta = -0.073, p <0.01). In contrast, as the dependent variable, SSRH (R2 for model = 0.107) was independently associated with age, systolic blood pressure, low-density lipoprotein cholesterol, and body mass index. As the dependent variable, VRH was associated with the same risk factors with a slightly weaker R2 value of 0.095. In conclusion, SSRH and simply calculated VRH have stronger associations with cardiovascular risk factors than FMD. This may reflect greater sensitivity of these measures to detect early abnormalities associated with risk factors in a relatively young and healthy population.
尽管血流介导的血管舒张(FMD)被广泛应用,但用于测量心血管风险的理想血管参数尚不清楚。最近,有人提出充血期间的剪切应力和血流速度(VRH)可能比FMD与心血管危险因素有更强的相关性。本研究的目的是评估反应性充血期间的VRH和剪切应力(SSRH)与FMD的关系,以及这些测量指标与1477名无心血管疾病男性的心血管危险因素的关联。在双变量分析中,SSRH和VRH与FMD的相关性较弱(分别为r = 0.239,p <0.001和r = 0.108,p <0.001)。唯一与FMD独立相关的心血管危险因素是收缩压(β = -0.073,p <0.01)。相比之下,作为因变量,SSRH(模型的R2 = 0.107)与年龄、收缩压、低密度脂蛋白胆固醇和体重指数独立相关。作为因变量,VRH与相同的危险因素相关,R2值略低,为0.095。总之,SSRH和简单计算的VRH比FMD与心血管危险因素有更强的关联。这可能反映了这些测量指标在相对年轻和健康的人群中检测与危险因素相关的早期异常的更高敏感性。