Chung Chang-Min, Tseng Yu-Hsiang, Lin Yu-Sheng, Hsu Jen-Te, Wang Po-Chang
School of Traditional Chinese Medicine, College of Medicine, Chang Gung University, Taoyuan County, Taiwan ; Chang Gung University of Science and Technology, Chiayi County, Taiwan.
Division of Cardiology, Chang Gung Memorial Hospital, Chiayi, Taiwan.
Clin Interv Aging. 2015 Aug 20;10:1369-75. doi: 10.2147/CIA.S89568. eCollection 2015.
Brachial-ankle pulse wave velocity (baPWV) is a simple and reproducible measure of arterial stiffness and is extensively used to assess risk of cardiovascular disease in Asia. We examined whether baPWV was associated with coronary atherosclerosis and presence and extent of coronary artery disease (CAD) in older patients with chest pain.
This cross-sectional study enrolled 370 consecutive patients >65 years old who underwent baPWV measurement and elective coronary angiogram for suspected CAD at a single cardiovascular center, between June 2013 and July 2014.
In addition to diabetes mellitus and body mass index, baPWV was one of the statistically meaningful predictors of significant CAD (diameter of stenosis >50%) in a multivariate analysis. When the extent of CAD was classified as nonsignificant or significant CAD (ie, one-, two-, and three-vessel disease), there was a significant difference in baPWV between the significant and nonsignificant CAD groups, but not between the three significant CAD groups. Multivariate linear regression analyses showed that the number of diseased vessels and baPWV were both significantly associated with the SYNTAX (SYNergy between percutaneous coronary intervention with TAXus and cardiac surgery) score. The cutoff value of baPWV at 1,874 cm/s had a sensitivity of 60.1%, specificity of 70.8%, and area under receiver operating characteristic curve of 0.639 in predicting CAD.
Arterial stiffness determined by baPWV was associated independently with CAD severity, as assessed by angiography and the SYNTAX score in older patients with chest pain. As a result, increased arterial stiffness assessed by baPWV is associated with the severity and presence of CAD in older patients.
肱踝脉搏波速度（baPWV）是一种简单且可重复的动脉僵硬度测量指标，在亚洲被广泛用于评估心血管疾病风险。我们研究了baPWV是否与老年胸痛患者的冠状动脉粥样硬化以及冠状动脉疾病（CAD）的存在和程度相关。
这项横断面研究纳入了2013年6月至2014年7月期间在单一心血管中心连续370例年龄>65岁、因疑似CAD接受baPWV测量和选择性冠状动脉造影的患者。
在多变量分析中，除了糖尿病和体重指数外，baPWV是显著CAD（狭窄直径>50%）的统计学上有意义的预测指标之一。当CAD程度分为非显著或显著CAD（即单支、双支和三支血管病变）时，显著CAD组和非显著CAD组之间的baPWV存在显著差异，但三个显著CAD组之间无差异。多变量线性回归分析显示，病变血管数量和baPWV均与SYNTAX（紫杉醇药物洗脱支架置入术与心脏手术的协同作用）评分显著相关。baPWV在1874 cm/s时的截断值在预测CAD方面的敏感性为60.1%，特异性为70.8%，受试者操作特征曲线下面积为0.639。
在老年胸痛患者中，通过血管造影和SYNTAX评分评估，由baPWV确定的动脉僵硬度与CAD严重程度独立相关。因此，通过baPWV评估的动脉僵硬度增加与老年患者CAD的严重程度和存在相关。
