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动脉造影仪对脉搏波传播时间的磁共振成像视角及改善中心脉搏波速度主动脉长度估计的潜力

A magnetic resonance perspective of the pulse wave transit time by the Arteriograph device and potential for improving aortic length estimation for central pulse wave velocity.

作者信息

Rezai Mohammad-Reza, Cowan Brett R, Sherratt Neal, Finn Joseph D, Wu Frederick C W, Cruickshank J Kennedy

机构信息

Cardiovascular Research Group, Manchester Academic Health Science Centre, University of Manchester, Manchester, UK.

出版信息

Blood Press Monit. 2013 Apr;18(2):111-8. doi: 10.1097/MBP.0b013e32835d3663.

Abstract

BACKGROUND

Simple reproducible methods of measuring arterial stiffness, a powerful index of prognosis, are becoming available.

AIM

To compare the pulse wave transit time (TT) and pulse wave velocity (PWV) between MRI and an arm cuff-based oscillometric method, the Arteriograph.

MATERIALS AND METHODS

MRI phase-contrast data were acquired at the aortic arch and just above the aortic bifurcation in 49 men (age 53±6 years). Supine left-arm Arteriograph measurements were made after MRI using the surface sternal notch to symphysis pubis pathway length.

RESULTS

MRI TT and PWV covered 86% of aortic root-bifurcation length omitting a mean 4.7 cm of proximal ascending aorta. Arteriograph TT (71±9 ms) was 6.6 ms [95% confidence interval (CI) 3.9-9.4] or 10% higher than MRI (64±10 ms). Arteriograph PWV (7.9±1.3 m/s) was 1.33 m/s (95% CI 0.95-1.70) higher than MRI (6.6±1.2 m/s), primarily because the surface aortic length was 70 mm (95% CI 59-81) longer than MRI. Arteriograph-MRI PWV difference decreased to 0.31 m/s (95% CI 0.01-0.61) when Arteriograph PWV was calculated using the MRI aortic path length and to 0.25 m/s (95% CI -0.05 to 0.55) after correcting for the aortic segments omitted in the MRI method. After similar TT corrections for MRI, the Arteriograph-MRI difference in TT reduced to 3.2 ms (95% CI 0.2-6).

CONCLUSION

TT estimations by Arteriograph and MRI are close. More accurate length estimation from MRI-derived models improves Arteriograph PWV measurement.

摘要

背景

测量动脉僵硬度(一种强大的预后指标)的简单可重复方法已逐渐可用。

目的

比较磁共振成像(MRI)与基于手臂袖带的示波法(动脉造影仪)之间的脉搏波传播时间(TT)和脉搏波速度(PWV)。

材料与方法

对49名男性(年龄53±6岁)在主动脉弓和主动脉分叉上方进行MRI相位对比数据采集。MRI检查后,使用胸骨上切迹至耻骨联合的体表路径长度,对仰卧位左臂进行动脉造影仪测量。

结果

MRI的TT和PWV覆盖了主动脉根部至分叉长度的86%,近端升主动脉平均遗漏4.7厘米。动脉造影仪的TT(71±9毫秒)比MRI(64±10毫秒)高6.6毫秒[95%置信区间(CI)3.9 - 9.4],即高10%。动脉造影仪的PWV(7.9±1.3米/秒)比MRI(6.6±1.2米/秒)高1.33米/秒(95% CI 0.95 - 1.70),主要是因为体表主动脉长度比MRI长70毫米(95% CI 59 - 81)。当使用MRI主动脉路径长度计算动脉造影仪PWV时,动脉造影仪与MRI的PWV差值降至0.31米/秒(95% CI 0.01 - 0.61),在对MRI方法中遗漏的主动脉节段进行校正后,差值降至0.25米/秒(95% CI -0.05至0.55)。对MRI进行类似的TT校正后,动脉造影仪与MRI的TT差值降至3.2毫秒(95% CI 0.2 - 6)。

结论

动脉造影仪和MRI对TT的估计相近。基于MRI模型进行更准确的长度估计可改善动脉造影仪对PWV的测量。

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