University of Queensland School of Medicine, Brisbane, Queensland,Australia.
J Hum Hypertens. 2010 Apr;24(4):254-62. doi: 10.1038/jhh.2009.92. Epub 2010 Jan 21.
There are several methods of assessing total arterial compliance (TAC) based on the two element Windkessel model, which is a ratio of pressure and volume, but the optimal technique is unclear. In this study, three methods of estimating TAC were compared to determine which was the most robust in a large group of patients with and without cardiovascular risk. In all, 320 patients (170 men; age 55+/-10) were studied; TAC was determined by the pulse-pressure method (PPM), the area method (AM) and the stroke volume/pulse-pressure method (SVPP). We obtained arterial waveforms using radial applanation tonometry, dimensions using two-dimensional echocardiography and flow data by Doppler. Clinical data, risk factors, echo parameters and TAC by all three methods were then compared. TAC (ml mm Hg(-1)) by the PPM was 1.24+/-0.51, by the AM 1.84+/-0.90 and by the SVPP 1.96+/-0.76 (P<0.0001 between groups). Correlation was good between all methods: PPM/AM r=0.83, PPM/SVPP r=0.94 and AM/SVPP r=0.80 (all P<0.0001). Subgroup analysis showed significant differences between patients with and those without cardiovascular risk for all three methods; TAC-AM and TAC-SVPP values were similar and significantly higher than TAC-PPM. The only significant relationships observed with TAC and echo parameters were in left ventricular (LV) septal thickness (R(2)=0.07; P<0.0001) and LV mass (R(2)=0.04; P=0.004). Normal and abnormal values of TAC vary according to method, which should be expressed. Each of the techniques shows good correlation with each other, however, values for TAC-PPM are significantly lower. TAC-PPM and TAC-SVPP are comparable in determining differences between groups with and without cardiovascular risk.
有几种基于两元素风箱模型评估总动脉顺应性（TAC）的方法，该模型是压力与容积的比值，但最佳技术尚不清楚。在这项研究中，比较了三种估计 TAC 的方法，以确定在患有和不患有心血管风险的大量患者中哪种方法最稳健。共有 320 名患者（男性 170 名；年龄 55+/-10）接受了研究；TAC 通过脉搏压法（PPM）、面积法（AM）和每搏量/脉搏压法（SVPP）确定。我们使用桡动脉平面张力测定法获得动脉波形，使用二维超声心动图获得尺寸，使用多普勒获得流量数据。然后比较了所有三种方法的临床数据、危险因素、超声心动图参数和 TAC。PPM 法 TAC（ml mm Hg(-1)）为 1.24+/-0.51，AM 法为 1.84+/-0.90，SVPP 法为 1.96+/-0.76（组间差异 P<0.0001）。所有方法之间相关性良好：PPM/AM r=0.83，PPM/SVPP r=0.94，AM/SVPP r=0.80（均 P<0.0001）。亚组分析显示，所有三种方法的心血管风险患者与无心血管风险患者之间存在显著差异；TAC-AM 和 TAC-SVPP 值相似，且明显高于 TAC-PPM。与 TAC 和超声心动图参数唯一显著相关的是左心室（LV）室间隔厚度（R(2)=0.07；P<0.0001）和 LV 质量（R(2)=0.04；P=0.004）。TAC 的正常和异常值因方法而异，应予以表示。每种技术彼此之间均显示出良好的相关性，但 TAC-PPM 的值明显较低。TAC-PPM 和 TAC-SVPP 在确定有和无心血管风险的组之间的差异方面具有可比性。
