Palmiero Pasquale, Maiello Maria, Daly David D, Ciccone Marco Matteo, Nanda Navin C
ASL BR, District Cardiology Brindisi, Italy.
Echocardiography. 2012 Nov;29(10):1233-8. doi: 10.1111/j.1540-8175.2012.01786.x. Epub 2012 Aug 17.
The first goal of our study was to investigate major determinants of aortic stiffness in postmenopausal women using an echocardiographic method to calculate global pulse wave velocity (PWVg) rather than the less accurate carotid-femoral pulse wave velocity (PWVc). The second goal was to relate PWVg to the absolute risk of major cardiovascular (CV) events estimated by CV risk factors.
Two hundred forty-four consecutive women who presented to our heart station were screened. One hundred twenty-two were postmenopausal, either natural or surgical, whereas 122 were premenopausal. The mean age of the patients was 54 ± 13 years. Individuals were categorized as current smokers, former smokers, or nonsmokers and hypertensive or not. Hypercholesterolemia and diabetes mellitus were defined. Aortic stiffness was assessed by PWVg measured with pulsed Doppler, the interval between the beginning of QRS complex and the foot of the systolic upstroke in the Doppler spectral envelope was calculated at the aortic valve site and at the right common femoral artery. PWVg was calculated between the aortic valve and right common femoral artery by dividing the straight line distance between the two by the transit time.
There was a highly significant statistical difference (P < 0.0012) in PWVg between menstruating women and postmenopausal women. Similarly, this difference in PWVg was also noted among the menstruating population (P < 0.0014) when comparing normotensive women and hypertensive women. In postmenopausal women, PWVg was 6.8 m/sec in normotensive women and 7.56 m/sec in hypertensive women (P < 0.007).
PWVg was increased in postmenopausal women compared with menstruating women. Systemic hypertension has an independent, but additive effect on aortic stiffness assessed by PWVg. Our study supports the usefulness of the assessment of aortic stiffness as a marker of CV disease and to identify subjects at risk at an early age.
我们研究的首要目标是使用超声心动图方法计算整体脉搏波速度（PWVg），而非准确性较低的颈股脉搏波速度（PWVc），来研究绝经后女性主动脉僵硬度的主要决定因素。第二个目标是将PWVg与通过心血管（CV）危险因素估计的主要心血管事件的绝对风险联系起来。
对连续就诊于我们心脏科的244名女性进行筛查。其中122名是自然绝经或手术绝经后的女性，122名是绝经前女性。患者的平均年龄为54±13岁。将个体分为当前吸烟者、既往吸烟者或非吸烟者，以及高血压患者或非高血压患者。定义了高胆固醇血症和糖尿病。通过脉冲多普勒测量PWVg评估主动脉僵硬度，在主动脉瓣部位和右股总动脉处计算QRS波群起始与多普勒频谱包络中收缩期上升支起点之间的时间间隔。通过将两者之间的直线距离除以传播时间来计算主动脉瓣与右股总动脉之间的PWVg。
月经周期女性与绝经后女性的PWVg存在高度显著的统计学差异（P<0.0012）。同样，在比较血压正常女性和高血压女性时，月经周期人群中也注意到了PWVg的这种差异（P<0.0014）。在绝经后女性中，血压正常女性的PWVg为6.8米/秒，高血压女性为7.56米/秒（P<0.007）。
与月经周期女性相比，绝经后女性的PWVg升高。系统性高血压对通过PWVg评估的主动脉僵硬度有独立但叠加的影响。我们的研究支持将主动脉僵硬度评估作为心血管疾病标志物以及早期识别高危人群的有用性。
