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动脉顺应性和踝臂指数的无创测量指标的相关性:动脉粥样硬化的多民族研究(MESA)。

Associations of noninvasive measures of arterial compliance and ankle-brachial index: the Multi-Ethnic Study of Atherosclerosis (MESA).

机构信息

The Department of Medicine, Northwestern University Feinberg School of Medicine, Chicago, Illinois, USA.

出版信息

Am J Hypertens. 2012 May;25(5):535-41. doi: 10.1038/ajh.2012.13. Epub 2012 Feb 23.

Abstract

BACKGROUND

The association between measures of arterial compliance and peripheral arterial disease (PAD) is unclear. Early changes in arterial wall compliance could be a useful marker of patients at high risk for developing lower extremity atherosclerosis.

METHODS

We used linear and logistic regression models on baseline data from 2,803 female and 2,558 male participants in the Multi-Ethnic Study of Atherosclerosis (MESA) to study associations between tonometry-derived baseline measures of arterial compliance (large artery compliance (C1) and small artery compliance (C2)) and the baseline ankle-brachial index (ABI), as well as change in the ABI over ~3 years of follow-up.

RESULTS

In cross-sectional analyses, lower C1 and C2 values, indicating poorer arterial compliance, were associated with lower ABI. There were significant linear trends across strata of ABI, especially in C2 which ranged from 3.7 ml/mm Hg × 100 (95% confidence interval (CI) 3.3-4.2) in women with an ABI < 0.90 to 4.2 ml/mm Hg × 100 (95% CI 4.1-4.3 P < 0.001) in women with ABI 1.10 - <1.40. Similar significant trends (P < 0.001) were seen in men. In prospective analyses, those with the lowest tertile of C2 values at baseline had a greater multivariable-adjusted odds for decline in ABI of ≥ 0.15 over 3 years compared to those with the highest C2 values at baseline (odds ratio (OR) 1.80, 95% CI 1.23-2.64).

CONCLUSIONS

We observed that less compliant arteries were significantly associated with low ABI in cross-sectional analysis and with greater decline in odds of ABI over time.

摘要

背景

动脉顺应性与外周动脉疾病(PAD)之间的关系尚不清楚。动脉壁顺应性的早期变化可能是下肢动脉粥样硬化高危患者的有用标志物。

方法

我们使用多民族动脉粥样硬化研究(MESA)中 2803 名女性和 2558 名男性参与者的基线数据,使用线性和逻辑回归模型,研究了基于张力测量的基线动脉顺应性(大动脉顺应性(C1)和小动脉顺应性(C2))与基线踝臂指数(ABI)之间的关系,以及在大约 3 年的随访期间 ABI 的变化。

结果

在横断面分析中,较低的 C1 和 C2 值,表明动脉顺应性较差,与较低的 ABI 相关。在 ABI 分层中存在显著的线性趋势,尤其是 C2,其范围从女性 ABI <0.90 的 3.7 ml/mm Hg × 100(95%置信区间(CI)3.3-4.2)到女性 ABI 1.10-<1.40 的 4.2 ml/mm Hg × 100(95% CI 4.1-4.3 P <0.001)。在男性中也观察到类似的显著趋势(P <0.001)。在前瞻性分析中,与基线时 C2 值最低的三分位相比,基线时 C2 值最低的人在 3 年内 ABI 下降≥0.15的多变量调整后发生几率更高(比值比(OR)1.80,95% CI 1.23-2.64)。

结论

我们观察到,在横断面分析中,顺应性较差的动脉与 ABI 降低显著相关,并且随着时间的推移,ABI 下降的几率更大。

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