3rd Department of Medicine, General Faculty Hospital, 1st Medical Faculty, Charles University in Prague, Prague 2, Czech Republic.
Hypertens Res. 2010 May;33(5):454-9. doi: 10.1038/hr.2010.12. Epub 2010 Feb 26.
The aim of the study was to evaluate arterial stiffness and its modulating factors measured by carotid-femoral pulse wave velocity (PWV) and central augmentation index (AI) in patients with pheochromocytoma (PHEO) before and after surgery. Forty-five patients with PHEO and 45 healthy controls were investigated using an applanation tonometer (SphygmoCor, AtCor Medical). The gender, age, BMI and lipid profiles were comparable among both groups. The main difference in basic characteristic was as expected for fasting plasma glucose (P<0.001) and all blood pressure modalities. PWV in PHEO was significantly higher than in controls (7.2+/-1.4 vs. 5.8+/-0.5 ms(-1); P<0.001). Between-group difference in PWV remained significant even after the adjustment for age, heart rate, fasting plasma glucose and each of brachial (P<0.001) and 24 h blood pressure parameters (P<0.01). The difference in AI between groups did not reach the statistical significance (19+/-14 vs. 16+/-13%; NS). In multiple regression analysis, age (P<0.001), mean blood pressure (P=0.002), high-sensitive C-reactive protein (hs-CRP) (P=0.007) and 24 h urine norepinephrine (P=0.007) were independently associated with PWV in PHEO. In addition, 27 patients with PHEO were studied 1 year after tumor removal. Successful tumor removal led to a significant decrease in PWV (7.0+/-1.2 vs. 6.0+/-1.1 ms(-1); P<0.001). In conclusion, patients with PHEO have an increase in PWV, which is reversed by the successful tumor removal. Age, mean blood pressure, hs-CRP and norepinephrine levels are independent predictors of PWV.
研究目的在于评估通过颈股脉搏波速度（PWV）和中心增强指数（AI）测量的嗜铬细胞瘤（PHEO）患者手术前后的动脉僵硬程度及其调节因素。使用平板式血压计（SphygmoCor，AtCor Medical）对 45 例 PHEO 患者和 45 名健康对照者进行了调查。两组间的性别、年龄、BMI 和血脂谱相当。两组间的基本特征主要差异在于空腹血糖（P<0.001）和所有血压模式。PHEO 患者的 PWV 明显高于对照组（7.2+/-1.4 vs. 5.8+/-0.5 ms(-1)；P<0.001）。即使在校正年龄、心率、空腹血糖以及肱动脉（P<0.001）和 24 小时血压参数（P<0.01）后，两组间的 PWV 差异仍具有统计学意义。两组间 AI 的差异无统计学意义（19+/-14 vs. 16+/-13%；NS）。多元回归分析显示，年龄（P<0.001）、平均血压（P=0.002）、高敏 C 反应蛋白（hs-CRP）（P=0.007）和 24 小时尿去甲肾上腺素（P=0.007）与 PHEO 患者的 PWV 独立相关。此外，对 27 例 PHEO 患者进行了肿瘤切除 1 年后的研究。肿瘤切除成功导致 PWV 显著降低（7.0+/-1.2 vs. 6.0+/-1.1 ms(-1)；P<0.001）。总之，PHEO 患者的 PWV 增加，且成功肿瘤切除后 PWV 逆转。年龄、平均血压、hs-CRP 和去甲肾上腺素水平是 PWV 的独立预测因子。
