Joo Hyung Joon, Cho Sang-A, Cho Jae-Young, Lee Seunghun, Park Jae Hyoung, Hwang Sung Ho, Hong Soon Jun, Yu Cheol Woong, Lim Do-Sun
Department of Cardiology, Cardiovascular Center, Korea University Anam Hospital.
J Atheroscler Thromb. 2016 Sep 1;23(9):1033-46. doi: 10.5551/jat.33084. Epub 2016 Jun 1.
Although arterial stiffness has been associated with the development of atherosclerosis, the role of brachial-ankle pulse wave velocity (baPWV) for diagnosing composite coronary and carotid atherosclerosis has not been completely elucidated.
We enrolled 773 asymptomatic individuals who were referred from 25 public health centers in Seoul and who underwent carotid ultrasonography and coronary computed tomography. Non-invasive hemodynamic parameters, including baPWV, were also measured. Composite coronary and carotid atherosclerosis was defined as follows: 1) coronary artery calcium (CAC) score ≥ 100, 2) coronary artery stenosis (CAS) ≥ 50% of diameter stenosis, 3) carotid intima medial thickness (CIMT) ≥ 0.9 mm, or 4) presence of carotid artery plaque (CAP).
The incidence of composite coronary and carotid atherosclerosis was 28.2%. Coronary atherosclerosis (CAC and CAS) was significantly associated with carotid atherosclerosis (CIMT and CAP). Subjects with higher baPWV (highest quartile) had a higher prevalence of composite coronary and carotid atherosclerosis (p<.001). Although multivariate analysis failed to show baPWV as an independent predictor for composite atherosclerosis, baPWV had moderate diagnostic power to detect a subject with more than two positive subclinical atherosclerosis exams [area under the curve (AUC), 0.692].
baPWV was associated with the composite coronary and carotid atherosclerotic burden in a community-based asymptomatic population.
尽管动脉僵硬度与动脉粥样硬化的发展有关,但肱踝脉搏波速度(baPWV)在诊断冠状动脉和颈动脉复合性动脉粥样硬化中的作用尚未完全阐明。
我们纳入了773名无症状个体,这些个体来自首尔的25个公共卫生中心,并接受了颈动脉超声检查和冠状动脉计算机断层扫描。还测量了包括baPWV在内的无创血流动力学参数。冠状动脉和颈动脉复合性动脉粥样硬化的定义如下:1)冠状动脉钙化(CAC)评分≥100;2)冠状动脉狭窄(CAS)≥直径狭窄的50%;3)颈动脉内膜中层厚度(CIMT)≥0.9毫米;或4)存在颈动脉斑块(CAP)。
冠状动脉和颈动脉复合性动脉粥样硬化的发生率为28.2%。冠状动脉粥样硬化(CAC和CAS)与颈动脉粥样硬化(CIMT和CAP)显著相关。baPWV较高(最高四分位数)的受试者冠状动脉和颈动脉复合性动脉粥样硬化的患病率更高(p<0.001)。尽管多变量分析未能显示baPWV是复合性动脉粥样硬化的独立预测因子,但baPWV在检测有两项以上阳性亚临床动脉粥样硬化检查结果的受试者方面具有中等诊断能力[曲线下面积(AUC),0.692]。
在以社区为基础的无症状人群中,baPWV与冠状动脉和颈动脉复合性动脉粥样硬化负担相关。