Department of Medicine, Maastricht University Medical Centre, Maastricht, the Netherlands; Cardiovascular Research Institute Maastricht, Maastricht University Medical Centre, Maastricht, the Netherlands; School for Nutrition, Toxicology and Metabolism, Maastricht University Medical Centre, Maastricht, the Netherlands.
Department of Medicine, Maastricht University Medical Centre, Maastricht, the Netherlands; Cardiovascular Research Institute Maastricht, Maastricht University Medical Centre, Maastricht, the Netherlands.
J Am Coll Cardiol. 2014 May 6;63(17):1739-47. doi: 10.1016/j.jacc.2013.12.041. Epub 2014 Feb 26.
This study sought to investigate the association of local and segmental arterial stiffness with incident cardiovascular events and all-cause mortality.
The association of different stiffness indices, in particular of carotid, brachial, and femoral stiffness, with cardiovascular disease and mortality is currently unknown.
In a population-based cohort (n = 579, mean age 67 years, 50% women, 23% with type 2 diabetes [by design]), we assessed local stiffness of carotid, femoral, and brachial arteries (by ultrasonography), carotid-femoral pulse wave velocity (cfPWV), aortic augmentation index, and systemic arterial compliance.
After a median follow-up of 7.6 years, 130 participants had a cardiovascular event and 96 had died. The hazard ratios (HRs) (95% confidence intervals [CIs]) per 1 SD for cardiovascular events and all-cause mortality, respectively, were HR: 1.22 (95% CI: 0.95 to 1.56) and 1.51 (95% CI: 1.11 to 2.06) for lower carotid distensibility; HR: 1.19 (95% CI: 1.00 to 1.41) and 1.28 (95% CI: 1.07 to 1.53) for higher carotid elastic modulus; HR: 1.08 (95% CI: 0.88 to 1.31) and 1.43 (95% CI: 1.10 to 1.86) for lower carotid compliance; HR: 1.39 (95% CI: 1.06 to 1.83) and 1.27 (95% CI: 0.90 to 1.79) for lower femoral distensibility; HR: 1.25 (95% CI: 0.96 to 1.63) and 1.47 (95% CI: 1.01 to 2.13) for lower femoral compliance; and HR: 1.56 (95% CI: 1.23 to 1.98) and 1.13 (95% CI: 0.83 to 1.54) for higher cfPWV. These results were adjusted for age, sex, mean arterial pressure, and cardiovascular risk factors. Mutual adjustments for each of the other stiffness indices did not materially change these results. Brachial stiffness, augmentation index, and systemic arterial compliance were not associated with cardiovascular events or mortality.
Carotid and femoral stiffness indices are independently associated with incident cardiovascular events and all-cause mortality. The strength of these associations with events may differ per stiffness parameter.
本研究旨在探讨局部和节段性动脉僵硬与心血管事件和全因死亡率的关系。
不同僵硬指数的相关性，特别是颈动脉、肱动脉和股动脉僵硬与心血管疾病和死亡率的相关性，目前尚不清楚。
在一项基于人群的队列研究中（n=579，平均年龄 67 岁，50%为女性，23%患有 2 型糖尿病[按设计]），我们通过超声评估了颈动脉、股动脉和肱动脉的局部僵硬（分别为颈股脉搏波速度[cfPWV]、主动脉增强指数和系统动脉顺应性）。
中位随访 7.6 年后，130 名参与者发生心血管事件，96 名参与者死亡。分别每降低 1 个标准差的心血管事件和全因死亡率的风险比（HR）（95%置信区间[CI]）为 HR：1.22（95%CI：0.95 至 1.56）和 1.51（95%CI：1.11 至 2.06）的颈动脉可扩张性降低；HR：1.19（95%CI：1.00 至 1.41）和 1.28（95%CI：1.07 至 1.53）的颈动脉弹性模量升高；HR：1.08（95%CI：0.88 至 1.31）和 1.43（95%CI：1.10 至 1.86）的颈动脉顺应性降低；HR：1.39（95%CI：1.06 至 1.83）和 1.27（95%CI：0.90 至 1.79）的股动脉可扩张性降低；HR：1.25（95%CI：0.96 至 1.63）和 1.47（95%CI：1.01 至 2.13）的股动脉顺应性降低；HR：1.56（95%CI：1.23 至 1.98）和 1.13（95%CI：0.83 至 1.54）的 cfPWV 升高。这些结果是在调整了年龄、性别、平均动脉压和心血管危险因素后得出的。相互调整每个其他僵硬指数并没有实质性地改变这些结果。肱动脉僵硬、增强指数和系统动脉顺应性与心血管事件或死亡率无关。
颈动脉和股动脉僵硬指数与心血管事件和全因死亡率独立相关。这些关联与事件的强度可能因僵硬参数而异。
