Department of Clinical Physiology, University of Tampere and Tampere University Hospital, FI-33521, Tampere, Finland.
Atherosclerosis. 2012 Feb;220(2):387-93. doi: 10.1016/j.atherosclerosis.2011.08.007. Epub 2011 Aug 10.
Increased arterial pulse wave velocity (PWV) is a strong predictor of cardiovascular events and mortality. The data regarding the relationships between PWV and other indices of vascular damage is limited and partly controversial. We conducted the present study to examine PWV in relation to non-invasive measures of early atherosclerosis (brachial flow-mediated dilation [FMD], carotid intima-media thickness [IMT]) and local arterial stiffness (carotid artery distensibility [Cdist]).
The study population consisted of 1754 young adults (aged 30-45 years, 45.5% males) participating in the Cardiovascular Risk in Young Finns Study (YFS), and of 336 older adults (aged 46-76 years, 43.2% males) participating in the Health 2000 Survey. FMD was measured only in the YFS cohort. FMD, IMT and Cdist were assessed by ultrasound, and PWV was measured using the whole-body impedance cardiography device.
In young adults, FMD and IMT were not associated with PWV independently of cardiovascular risk factors. Moreover, FMD status was not found to modulate the association between cardiovascular risk factors and PWV. In older adults, PWV and IMT were directly and independently associated (β=1.233, p=0.019). In both cohorts, PWV was inversely related with Cdist, and this relation remained significant (p<0.04) in models adjusted for cardiovascular risk factors.
The current findings suggest that PWV reflects a different aspect of vascular damage than FMD or IMT in young adults, whereas in older adults the information provided by PWV and IMT may be, to some extent, similar as regards subclinical vascular damage. The present observations also suggest that PWV and Cdist represent, at least in part, a similar adverse vascular wall process.
脉搏波速度(PWV)的增加是心血管事件和死亡率的强有力预测因子。关于 PWV 与血管损伤其他指标之间关系的数据有限且部分存在争议。我们进行了本研究,以检查 PWV 与早期动脉粥样硬化的非侵入性测量指标(肱动脉血流介导的舒张功能[FMD]、颈动脉内膜中层厚度[IMT])和局部动脉僵硬度(颈动脉可扩张性[Cdist])之间的关系。
研究人群包括参加心血管风险在年轻芬兰人中的研究(YFS)的 1754 名年轻成年人(年龄 30-45 岁,45.5%为男性)和参加健康 2000 调查的 336 名老年人(年龄 46-76 岁,43.2%为男性)。仅在 YFS 队列中测量 FMD。通过超声评估 FMD、IMT 和 Cdist,使用全身阻抗心动图仪测量 PWV。
在年轻成年人中,FMD 和 IMT 与 PWV 无关,独立于心血管危险因素。此外,FMD 状态未发现调节心血管危险因素与 PWV 之间的关联。在老年人中,PWV 和 IMT 直接且独立相关(β=1.233,p=0.019)。在两个队列中,PWV 与 Cdist 呈负相关,且在调整心血管危险因素的模型中,该相关性仍然显著(p<0.04)。
目前的研究结果表明,在年轻成年人中,PWV 反映了与 FMD 或 IMT 不同的血管损伤方面,而在老年人中,PWV 和 IMT 提供的信息在某种程度上可能与亚临床血管损伤相似。本研究还表明,PWV 和 Cdist 至少部分代表了相似的不利血管壁过程。