Cardiovascular Pathophysiology and Genomics Research Unit, Faculty of Health Sciences, School of Physiology, University of the Witwatersrand Medical School, Johannesburg, South Africa.
Faculty of Health Sciences, The School of Medicine, University of the Witwatersrand, Johannesburg, South Africa.
Hypertens Res. 2014 Nov;37(11):1021-7. doi: 10.1038/hr.2014.113. Epub 2014 Jul 10.
Although indices of aortic augmentation derived from radial applanation tonometry are independently associated with adverse cardiovascular effects, whether these relationships are influenced by gender is uncertain. We compared the brachial blood pressure-independent contribution of augmentation index (AIx) to variations in left ventricular mass index (LVMI) in a community sample of 808 participants, 283 of whom were men. Aortic haemodynamics were determined using radial applanation tonometry and SphygmoCor software and LVMI from echocardiography. In men, both AIx derived from aortic augmentation pressure/central aortic pulse pressure (AP/PPc; partial r = 0.17, β-coefficient ± s.e.m. = 0.55 ± 0.20, P < 0.01) and AIx derived from the second peak/first peak (P2/P1) of the aortic pulse wave (partial r = 0.21, β-coefficient ± s.e.m. = 0.42 ± 0.12, P<0.0005) were associated with LVM indexed to body surface area (LVMI-BSA). In contrast, in women, neither AIx derived from AP/PPc (partial r = -0.08, β-coefficient ± s.e.m.=-0.20 ± 0.11, P = 0.08) nor AIx derived from P2/P1 (partial r = -0.06, β-coefficient ± s.e.m. = -0.07 ± 0.05, P = 0.17) were associated with LVMI-BSA. Both the strength of the correlations (P<0.001 and P<0.0005 with z-statistics) and the slope of the AIx-LVMI relationships (P=0.001 and P<0.0005) were greater in men as compared with women. The lack of relationship between AIx and LVMI was noted in both premenopausal (n=285; AP/PPc vs. LVMI-BSA, partial r = 0.01, P = 0.95, P2/P1 vs. LVMI-BSA, partial r = 0.02, P = 0.77), and postmenopausal (n = 240; AP/PPc vs. LVMI-BSA, partial r = -0.06, P = 0.37, P2/P1 vs. LVMI-BSA, partial r = -0.03, P = 0.64) women. Similar differences were noted in the relationships between AIx and LVM indexed to height(2.7) in men and women. In conclusion, radial applanation tonometry-derived AIx may account for less of the variation in end-organ changes in women as compared with men.
虽然源自桡动脉压力测量的主动脉增强指数与不良心血管影响独立相关，但这些关系是否受性别影响尚不确定。我们比较了 808 名参与者的肱动脉血压独立贡献指数（AIx）对左心室质量指数（LVMI）变化的影响，其中 283 名为男性。使用桡动脉平板压力测量和 SphygmoCor 软件确定主动脉血流动力学，使用超声心动图确定 LVMI。在男性中，主动脉增强压/中心主动脉脉搏压（AP/PPc）衍生的 AIx（部分 r = 0.17，β 系数 ± s.e.m. = 0.55 ± 0.20，P < 0.01）和主动脉脉搏波的第二峰/第一峰（P2/P1）衍生的 AIx（部分 r = 0.21，β 系数 ± s.e.m. = 0.42 ± 0.12，P<0.0005）与身体表面积指数的 LVMI（LVMI-BSA）相关。相比之下，在女性中，AP/PPc 衍生的 AIx（部分 r = -0.08，β 系数 ± s.e.m. = -0.20 ± 0.11，P = 0.08）和 P2/P1 衍生的 AIx（部分 r = -0.06，β 系数 ± s.e.m. = -0.07 ± 0.05，P = 0.17）均与 LVMI-BSA 不相关。与女性相比，相关性的强度（P<0.001 和 P<0.0005 与 z 统计量）和 AIx-LVMI 关系的斜率（P = 0.001 和 P<0.0005）在男性中更高。在绝经前（n=285；AP/PPc 与 LVMI-BSA，部分 r = 0.01，P = 0.95，P2/P1 与 LVMI-BSA，部分 r = 0.02，P = 0.77）和绝经后（n=240；AP/PPc 与 LVMI-BSA，部分 r = -0.06，P = 0.37，P2/P1 与 LVMI-BSA，部分 r = -0.03，P = 0.64）女性中，AIx 与 LVMI 之间均未发现关系。在男性和女性中，AIx 与身高指数（2.7）的关系也存在类似的差异。总之，与男性相比，桡动脉平板压力测量衍生的 AIx 可能解释了女性终末器官变化的变化较小。
