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健康志愿者的主动脉僵硬度与副交感自主神经功能之间的相关性。

Correlations between aortic stiffness and parasympathetic autonomic function in healthy volunteers.

机构信息

2nd Department of Medicine and Cardiology Center, Medical Faculty, Albert Szent-Györgyi Clinical Center, University of Szeged, Szeged, Hungary.

出版信息

Can J Physiol Pharmacol. 2010 Dec;88(12):1166-71. doi: 10.1139/Y10-095.

DOI:10.1139/Y10-095
PMID:21164563
Abstract

Cardiovascular autonomic dysfunction and alterations in vascular elasticity are known complications of several disorders, including diabetes mellitus, hypertension, hypercholesterolemia, aging, and chronic kidney disease. The current study was designed to test whether a relationship existed between pulse wave velocity (PWV), augmentation index (AIx), aortic elastic properties, and cardiovascular autonomic function in healthy volunteers. The study comprised 25 healthy volunteers, whose aortic strain, distensibility, and stiffness index were measured by echocardiography, whereas PWV and AIx were evaluated by Arteriograph (TensioMed, Budapest, Hungary) in all cases. Autonomic function was assessed by means of 5 standard cardiovascular reflex tests. We found that heart rate response to deep breathing, as the most reproducible cardiovascular reflex test to characterize parasympathetic function, showed low to moderate correlations with PWV (r = -0.431, p = 0.032), aortic strain (r = 0.594, p = 0.002), distensibility (r = 0.407, p = 0.043), and stiffness index (r = -0.453, p = 0.023). Valsalva ratio and autonomic neuropathy score (ANS) correlated with PWV (r = -0.557, p = 0.004 and r = -0.421, p = 0.036, respectively) and AIx (r = -0.461, p = 0.020 and r = -0.385, p = 0.057, respectively), while ANS correlated with even aortic stiffness index (r = -0.457, p = 0.022). Cardiovascular reflex tests mainly characterizing sympathetic function had no correlation with aortic stiffness parameters (p = NS for all correlations). Correlations exist between parameters characterizing aortic elasticity and parasympathetic autonomic function, as shown by standard cardiovascular reflex tests in healthy volunteers.

摘要

心血管自主神经功能障碍和血管弹性改变是多种疾病的已知并发症,包括糖尿病、高血压、高胆固醇血症、衰老和慢性肾脏病。本研究旨在测试健康志愿者的脉搏波速度(PWV)、增强指数(AIx)、主动脉弹性特性和心血管自主功能之间是否存在关系。该研究包括 25 名健康志愿者,通过超声心动图测量其主动脉应变、可扩张性和僵硬指数,而所有患者均通过 Arteriograph(TensioMed,布达佩斯,匈牙利)评估 PWV 和 AIx。自主功能通过 5 项标准心血管反射测试进行评估。我们发现,作为最能重现的用于描述副交感神经功能的心血管反射测试,心率对深呼吸的反应与 PWV(r = -0.431,p = 0.032)、主动脉应变(r = 0.594,p = 0.002)、可扩张性(r = 0.407,p = 0.043)和僵硬指数(r = -0.453,p = 0.023)呈低至中度相关。瓦尔萨尔瓦动作比值和自主神经病变评分(ANS)与 PWV(r = -0.557,p = 0.004 和 r = -0.421,p = 0.036)和 AIx(r = -0.461,p = 0.020 和 r = -0.385,p = 0.057)相关,而 ANS 与甚至主动脉僵硬指数(r = -0.457,p = 0.022)相关。主要用于描述交感神经功能的心血管反射测试与主动脉僵硬参数之间没有相关性(所有相关性的 p = NS)。在健康志愿者中,通过标准心血管反射测试显示,主动脉弹性特性和副交感自主功能之间存在相关性。

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