Tsao Connie W, Pencina Karol M, Massaro Joseph M, Benjamin Emelia J, Levy Daniel, Vasan Ramachandran S, Hoffmann Udo, O'Donnell Christopher J, Mitchell Gary F
From the Department of Medicine, Cardiovascular Division, Beth Israel Deaconess Medical Center, Boston, MA (C.W.T.); Departments of Biostatistics (K.M.P., J.M.M.) and Epidemiology (E.J.B.), School of Public Health, and Department of Medicine, Sections of Cardiology and Preventative Medicine (E.J.B., R.S.V.), Boston University School of Medicine, MA; National Heart, Lung, and Blood Institute, Bethesda, MD (D.L.); The Framingham Heart Study, MA (C.W.T., E.J.B., D.L., R.S.V., C.J.O.); Division of Intramural Research, NHLBI, Bethesda, MD (C.W.T., C.J.O.); Division of Cardiology, Department of Medicine (C.J.O.) and Department of Radiology (U.H.), Massachusetts General Hospital, Boston; and Cardiovascular Engineering Inc, Norwood, MA (G.F.M.).
Arterioscler Thromb Vasc Biol. 2014 Nov;34(11):2495-500. doi: 10.1161/ATVBAHA.114.303916. Epub 2014 Aug 28.
Arterial hemodynamics and vascular calcification are associated with increased risk for cardiovascular disease, but their inter-relations remain unclear. We sought to examine the associations of arterial stiffness, pressure pulsatility, and wave reflection with arterial calcification in individuals free of prevalent cardiovascular disease.
Framingham Heart Study Third Generation and Offspring Cohort participants free of cardiovascular disease underwent applanation tonometry to measure arterial stiffness, pressure pulsatility, and wave reflection, including carotid-femoral pulse wave velocity, central pulse pressure, forward wave amplitude, and augmentation index. Participants in each cohort (n=1905, 45±6 years and n=1015, 65±9 years, respectively) underwent multidetector computed tomography to assess the presence and quantity of thoracic aortic calcification, abdominal aortic calcification, and coronary artery calcification. In multivariable-adjusted models, both higher carotid-femoral pulse wave velocity and central pulse pressure were associated with greater thoracic aortic calcification and abdominal aortic calcification, whereas higher augmentation index was associated with abdominal aortic calcification. Among the tonometry measures, carotid-femoral pulse wave velocity was the strongest correlate of all calcification measures in multivariable-adjusted models (odds ratio per SD for thoracic aortic calcification, 2.69 [95% confidence interval, 2.17-3.35]; abdominal aortic calcification, 1.47 [95% confidence interval, 1.26-1.73]; and coronary artery calcification, 1.48 [95% confidence interval, 1.28-1.72]; all P<0.001, respectively). We observed stronger relations of carotid-femoral pulse wave velocity, central pulse pressure, and forward wave amplitude with nearly all continuous calcification measures in the younger Third Generation Cohort as compared with the Offspring Cohort.
In community-dwelling individuals without prevalent cardiovascular disease, abnormal central arterial hemodynamics were positively associated with vascular calcification and were observed at younger ages than previously recognized. The mechanisms of these associations may be bidirectional and deserve further study.
动脉血流动力学和血管钙化与心血管疾病风险增加相关，但其相互关系仍不明确。我们旨在研究在无心血管疾病的个体中，动脉僵硬度、压力搏动性和波反射与动脉钙化之间的关联。
弗雷明汉心脏研究第三代和子代队列中无心血管疾病的参与者接受了压平式眼压测量，以测量动脉僵硬度、压力搏动性和波反射，包括颈股脉搏波速度、中心脉压、前向波振幅和增强指数。每个队列的参与者（分别为n = 1905，45±6岁和n = 1015，65±9岁）接受了多排螺旋计算机断层扫描，以评估胸主动脉钙化、腹主动脉钙化和冠状动脉钙化的存在及数量。在多变量调整模型中，较高的颈股脉搏波速度和中心脉压均与胸主动脉钙化和腹主动脉钙化程度加重相关，而较高的增强指数与腹主动脉钙化相关。在眼压测量指标中，颈股脉搏波速度是多变量调整模型中所有钙化指标的最强相关因素（胸主动脉钙化每标准差的比值比为2.69 [95%置信区间，2.17 - 3.35]；腹主动脉钙化，1.47 [95%置信区间，1.26 - 1.73]；冠状动脉钙化，1.48 [95%置信区间，1.28 - 1.72]；所有P均<0.001）。与子代队列相比，我们在较年轻的第三代队列中观察到颈股脉搏波速度、中心脉压和前向波振幅与几乎所有连续钙化指标之间的关系更强。
在无心血管疾病的社区居民中，异常的中心动脉血流动力学与血管钙化呈正相关，且在比先前认识到的更年轻的年龄段就已出现。这些关联的机制可能是双向的，值得进一步研究。
