Löcsey L, Szlanka B, Borbás B, Szabó L, Dán A, Asztalos L, Fedor R, Ménes I, Lörincz I
Institute of Surgery, Medical and Health Science Center, University of Debrecen, Debrecen, Hungary.
Transplant Proc. 2010 Jul-Aug;42(6):2299-303. doi: 10.1016/j.transproceed.2010.05.017.
Arterial stiffness is an independent cardiovascular risk factor, along with aging, hypertension, and cardiovascular disease. The augmentation index (AIx) and pulse wave velocity (PWV) are early markers of atherosclerotic vascular changes. Arteriography was used to determine systolic and diastolic blood pressure, pulse pressure (PP), AIx, and PWV in 82 male and 64 female renal transplant recipients (mean [SD] age, 45.3 [11.2] years). Cardiovascular risk was assessed using echocardiography and ultrasonography of the carotid arteries. The left ventricular wall thickness, ejection fraction, and stenosis of the carotid arteries were also measured. Fasting serum creatinine, cystatin C, homocysteine, C-reactive protein, immunoreactive parathyroid hormone, lipid, and calcium-phosphorus concentrations were determined. The serum cystatin concentration was 2.1 (0.2) mg/L, and the homocysteine concentration, 15.2 (2.6) micromol/L. After transplantation, body mass index, fat mass, and visceral fat area increased significantly (P < .01). The AIx was increased (AIx > or =10%) in 20% of men and 37% of women, PWV was increased (>10 m/s) in 43% of men and 34% of women, and PP was pathologically high (>12 m/s) in 10% of men and 12% of women. The PWV was significantly related to age (r = 0.52) and ventricular wall thickness (r = 0.46). Pulse pressure, BMI, and systolic and diastolic blood pressure correlated positively but modestly with PWV. There was a significant relationship between AIx80 and systolic (r = 0.42) and diastolic (r = 0.39) blood pressure and PP (r = 0.33). The ejection fraction correlated negatively with PWV and AIx. There was a strong association between carotid artery stenosis, PWV, and AIx80. All patients with PWV greater than 10 m/s demonstrated carotid artery stenosis. In conclusion, arteriography is an objective, noninvasive, and convenient method for early diagnosis and follow-up of atherosclerosis.
动脉僵硬度是一种独立的心血管危险因素，与衰老、高血压和心血管疾病并存。增强指数（AIx）和脉搏波速度（PWV）是动脉粥样硬化血管变化的早期标志物。采用动脉造影术测定了82例男性和64例女性肾移植受者（平均[标准差]年龄，45.3[11.2]岁）的收缩压、舒张压、脉压（PP）、AIx和PWV。使用超声心动图和颈动脉超声评估心血管风险。还测量了左心室壁厚度、射血分数和颈动脉狭窄情况。测定了空腹血清肌酐、胱抑素C、同型半胱氨酸、C反应蛋白、免疫反应性甲状旁腺激素、血脂和钙磷浓度。血清胱抑素浓度为2.1（0.2）mg/L，同型半胱氨酸浓度为15.2（2.6）μmol/L。移植后，体重指数、脂肪量和内脏脂肪面积显著增加（P<0.01）。20%的男性和37%的女性AIx升高（AIx≥10%），43%的男性和34%的女性PWV升高（>10 m/s），10%的男性和12%的女性PP病理性升高（>12 m/s）。PWV与年龄（r = 0.52）和心室壁厚度（r = 0.46）显著相关。脉压、体重指数以及收缩压和舒张压与PWV呈正相关但相关性较弱。AIx80与收缩压（r = 0.42）、舒张压（r = 0.39）和脉压（r = 0.33）之间存在显著关系。射血分数与PWV和AIx呈负相关。颈动脉狭窄、PWV和AIx80之间存在密切关联。所有PWV大于10 m/s的患者均表现出颈动脉狭窄。总之，动脉造影术是一种用于动脉粥样硬化早期诊断和随访的客观、无创且便捷的方法。
