Tade Grace, Norton Gavin R, Booysen Hendrik L, Sibiya Moekanyi J, Ballim Imraan, Sareli Pinhas, Libhaber Elena, Majane Olebogeng H I, Woodiwiss Angela J
Cardiovascular Pathophysiology and Genomics Research Unit, School of Physiology, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa.
J Hypertens. 2017 Feb;35(2):300-309. doi: 10.1097/HJH.0000000000001173.
To determine the degree to which an extended time to the peak of the aortic forward wave or early wave reflection time enhance associations between aortic backward wave pressure and hence central aortic pulse pressure (PPc) and left ventricular mass index (LVMI).
In 701 adult participants from a community sample either receiving no antihypertensive therapy or receiving low-dose thiazide diuretic monotherapy for at least a year (the major therapy employed), we assessed aortic haemodynamics (SphygmoCor software and wave separation analysis; AtCor Medical, West Ryder, New South Wales, Australia) and LVMI (echocardiography).
An interaction between time to the peak of the aortic forward wave and aortic backward wave pressure was independently associated with aortic augmented pressure (P < 0.01), PPc (P < 0.005), LVMI (P < 0.01), and LV hypertrophy (LVH; P = 0.01). The time to the peak of the aortic forward wave-aortic backward wave pressure interaction translated into a stepwise increase in the independent association between aortic backward wave pressure and aortic augmented pressure or PPc across quartiles of time to the peak of the aortic forward wave (P < 0.05 to < 0.0001 for comparison of slopes of relations). Furthermore, the time to the peak of the aortic forward wave-aortic backward wave pressure interaction translated into an increase in the independent association between PPc or aortic backward wave pressure and LVMI (P < 0.05 to < 0.001 for comparison of slopes and strength of relations) or LVH (P < 0.05 for comparisons of odds ratios), but not between forward wave pressures and LVMI or LVH across quartiles of time to the peak of the aortic forward wave. A markedly better ability of aortic backward wave pressure and PPc, but not forward wave pressures to detect LVH was noted in the highest as compared with the first three quartiles of time to the peak of the aortic forward wave (P < 0.05). In contrast, reflection time failed to influence the impact of aortic backward wave pressure or PPc on LVMI.
Time to the peak of the aortic forward wave, but not early wave reflection markedly influences the impact of aortic backward wave pressure and hence aortic pulse pressure on LVMI and LVH in adults.
确定主动脉前向波峰值时间延长或早期波反射时间对主动脉逆向波压力以及中心主动脉脉压（PPc）和左心室质量指数（LVMI）之间关联的增强程度。
在701名来自社区样本的成年参与者中，他们要么未接受抗高血压治疗，要么接受低剂量噻嗪类利尿剂单药治疗至少一年（主要采用的治疗方法），我们评估了主动脉血流动力学（SphygmoCor软件和波分离分析；AtCor Medical，澳大利亚新南威尔士州韦斯特赖德）和LVMI（超声心动图）。
主动脉前向波峰值时间与主动脉逆向波压力之间的相互作用与主动脉增强压（P<0.01）、PPc（P<0.005）、LVMI（P<0.01）和左心室肥厚（LVH；P = 0.01）独立相关。主动脉前向波峰值时间 - 主动脉逆向波压力相互作用转化为在主动脉前向波峰值时间的四分位数范围内，主动脉逆向波压力与主动脉增强压或PPc之间的独立关联逐步增加（关系斜率比较，P<0.05至<0.0001）。此外，主动脉前向波峰值时间 - 主动脉逆向波压力相互作用转化为PPc或主动脉逆向波压力与LVMI（关系斜率和强度比较，P<0.05至<0.001）或LVH（优势比比较，P<0.05）之间独立关联的增加，但在主动脉前向波峰值时间的四分位数范围内，前向波压力与LVMI或LVH之间没有这种关联。与主动脉前向波峰值时间的前三个四分位数相比，在最高四分位数中，主动脉逆向波压力和PPc检测LVH的能力明显更好（P<0.05）。相比之下，反射时间未能影响主动脉逆向波压力或PPc对LVMI的影响。
主动脉前向波峰值时间而非早期波反射显著影响主动脉逆向波压力以及因此主动脉脉压对成年人LVMI和LVH的影响。
