Department of Integrated Medicine, Kagawa University, Japan.
J Atheroscler Thromb. 2012;19(3):255-62. doi: 10.5551/jat.10314. Epub 2011 Nov 7.
Plasma brain natriuteric peptide (BNP) is an established marker of cardiovascular events in individuals without heart failure. Although the cardio-ankle vascular index (CAVI) is clinically used as a parameter of arterial stiffness, its usefulness for predicting cardiovascular events has not been fully examined. This study aimed to evaluate the association among CAVIs, plasma BNP levels and left ventricular (LV) hypertrophy and dysfunction in hypertensive patients.
We enrolled 136 hypertensive patients (69±10 years) who had been taking antihypertensive medications for at least one year. Echocardiography was performed to evaluate LV hypertrophy and function. Plasma BNP levels and CAVIs were also measured simultaneously.
CAVI was correlated with plasma BNP (r =0.245, p =0.004). Multiple linear regression analysis revealed three independent determinants of CAVI: age (β =0.568, p <0.001), diameter of ascending aorta (β =0.289, p <0.001), and diabetes (β =0.207, p =0.003). In addition, multiple linear regression analysis revealed two independent determinants of the plasma BNP level: left atrial diameter (β =0.334, p <0.001) and CAVI (β =0.256, p =0.002).
The present study indicates that increased CAVI is independently associated with elevated plasma BNP produced by increased LV afterload, that is, arterial stiffness, in hypertensive patients. Moreover, the present study raises the possibility that CAVI may be as useful as the plasma BNP level for predicting the risk of cardiovascular events in hypertensive patients.
血浆脑钠肽(BNP)是心力衰竭患者心血管事件的既定标志物。尽管心血管-踝血管指数(CAVI)临床上用作动脉僵硬的参数,但尚未充分检查其预测心血管事件的有用性。本研究旨在评估 CAVI、血浆 BNP 水平与高血压患者左心室(LV)肥厚和功能障碍之间的关系。
我们纳入了 136 名高血压患者(69±10 岁),他们至少服用了一年的降压药物。进行超声心动图检查以评估 LV 肥厚和功能。同时测量血浆 BNP 水平和 CAVI。
CAVI 与血浆 BNP 相关(r =0.245,p =0.004)。多元线性回归分析显示 CAVI 的三个独立决定因素:年龄(β =0.568,p <0.001)、升主动脉直径(β =0.289,p <0.001)和糖尿病(β =0.207,p =0.003)。此外,多元线性回归分析显示血浆 BNP 水平的两个独立决定因素:左心房直径(β =0.334,p <0.001)和 CAVI(β =0.256,p =0.002)。
本研究表明,在高血压患者中,升高的 CAVI 与由 LV 后负荷增加引起的血浆 BNP 升高独立相关,即动脉僵硬。此外,本研究提出了一种可能性,即 CAVI 可能与血浆 BNP 水平一样,可用于预测高血压患者心血管事件的风险。