Department of Nephrology, Klinikum rechts der Isar, Technische Universität München, Munich, Germany.
Microcirculation. 2013 Jul;20(5):405-15. doi: 10.1111/micc.12036.
Hypertension is characterized by microvascular remodeling resulting in increased wall/lumen ratio and elevated microvascular stiffness. Aiming to transform the measurement of macrovascular stiffness into a microvascular environment we introduce a noninvasive method to assess rPWV. rPWV alterations in early hypertension are investigated in detail. The developed methodology is compared with its possible computational alternatives.
Time dependent alterations of retinal arterial diameter were assessed noninvasively by the DVA in 65 male normoalbuminuric normotensive to mildly hypertensive subjects (age: 28.7 ± 6.0 years). rPWV was computed using three different methods. "Method 1" used filtration at HR, "Method 2" filtered at higher HR multiples, and "Method 3" used in addition, linear fit for data averaging.
"Method 2" and "Method 3" applying filtration at high HR multiples showed strong associations with systolic BP throughout the cohort (r = 0.49, r = 0.63, p < 0.001). Based on the highest association, "Method 3" was proposed to characterize rPWV. Hypertensive patients showed higher rPWV (1243 ± 694 RU/sec) than subjects with high-normal BP (786 ± 486 RU/sec, p < 0.01) or normotensive subjects (442 ± 148 RU/sec, p < 0.001).
rPWV demonstrated a strong association with BP and can discriminate between optimal, high-normal, and mildly hypertensive BP values. rPWV may add detailed insights into early microvascular pathophysiology, potentially beyond microalbuminuria.
高血压的特征是微血管重构，导致壁腔比增加和微血管僵硬度升高。为了将大动脉僵硬度的测量转化为微血管环境，我们引入了一种评估相对脉搏波速度（rPWV）的非侵入性方法。详细研究了早期高血压中 rPWV 的变化。将开发的方法与可能的计算替代方法进行了比较。
通过 DVA 非侵入性地评估 65 名男性正常白蛋白尿正常血压至轻度高血压受试者（年龄：28.7±6.0 岁）的视网膜动脉直径随时间的变化。使用三种不同的方法计算 rPWV。“方法 1”在 HR 时进行滤波，“方法 2”在更高的 HR 倍数时进行滤波，“方法 3”除了使用数据平均的线性拟合外还进行滤波。
“方法 2”和“方法 3”在整个队列中均显示出与收缩压的强关联（r = 0.49，r = 0.63，p < 0.001）。基于最高关联，提出“方法 3”来描述 rPWV。高血压患者的 rPWV 高于高正常血压组（1243±694 RU/sec）（786±486 RU/sec，p < 0.01）或正常血压组（442±148 RU/sec，p < 0.001）。
rPWV 与血压有很强的关联，可以区分最佳、高正常和轻度高血压的血压值。rPWV 可能会提供有关早期微血管病理生理学的详细信息，可能超越微量白蛋白尿。
