Miyatani Masae, Alavinia S Mohammad, Szeto Maggie, Moore Cameron, Craven B Catharine
1 Brain and Spinal Cord Rehabilitation Program, Toronto Rehabilitation Institute-University Health Network, Canada.
2 Sleep Laboratory, Toronto Rehabilitation Institute, Canada.
Eur J Prev Cardiol. 2017 Mar;24(5):552-558. doi: 10.1177/2047487316687426. Epub 2017 Jan 24.
Aims To describe the association between cardiovascular risk factors and abnormal arterial stiffness, defined by a carotid-femoral pulse wave velocity ≥ 10 m/s, in patients with chronic spinal cord injury (SCI). Methods Ninety consenting adults with chronic SCI (C1-T10 ASIA Impairment Scale A-D) participated in this cross-sectional study. The cardiovascular risk factors considered included age, sex, duration of injury, neurological level of injury (C1-T1, tetraplegia; T2-T12, paraplegia), age at injury, impairment scale category, supine resting systolic blood pressure, diastolic blood pressure, mean arterial pressure, heart rate, leisure time physical activity, treated hypertension, treated hyperlipidemia, diabetes, lipid profiles, fasting blood glucose, glycated hemoglobin, and C reactive protein. Logistic regression analysis was used to determine the association between abnormal arterial stiffness and dichotomized cardiovascular risk factors. Results Dichotomized variables significantly associated with increased arterial stiffness were: age ≥ 52 years (OR 22.1, CI 4.28-113.99); systolic blood pressure ≥ 130 mmHg (OR 11.76, CI 2.89-47.88); heart rate ≥ 62 bpm (OR 6.62, CI 1.33-33.03); and paraplegia (OR 4.26, CI 1.00-18.33). The area under the receiver operating characteristic curve for probability of arterial stiffness was 0.920 (95% CI 0.861-0.978, p < 0.001). Conclusions Age, resting systolic blood pressure, resting heart rate, and neurological level of injury can identify patients at high risk of elevated arterial stiffness in the population with chronic SCI.
目的 描述慢性脊髓损伤(SCI)患者心血管危险因素与异常动脉僵硬度(定义为颈股脉搏波速度≥10 m/s)之间的关联。方法 90名同意参与的慢性SCI成年患者(C1-T10美国脊髓损伤协会损伤分级A-D级)参与了这项横断面研究。考虑的心血管危险因素包括年龄、性别、损伤持续时间、损伤神经平面(C1-T1,四肢瘫;T2-T12,截瘫)、受伤年龄、损伤分级类别、仰卧位静息收缩压、舒张压、平均动脉压、心率、休闲时间身体活动、治疗的高血压、治疗的高脂血症、糖尿病、血脂谱、空腹血糖、糖化血红蛋白和C反应蛋白。采用逻辑回归分析确定异常动脉僵硬度与二分心血管危险因素之间的关联。结果 与动脉僵硬度增加显著相关的二分变量为:年龄≥52岁(比值比22.1,可信区间4.28-113.99);收缩压≥130 mmHg(比值比11.76,可信区间2.89-47.88);心率≥62次/分钟(比值比6.62,可信区间1.33-33.03);以及截瘫(比值比4.26,可信区间1.00-18.33)。动脉僵硬度概率的受试者工作特征曲线下面积为0.920(95%可信区间0.861-0.978,p<0.001)。结论 年龄、静息收缩压、静息心率和损伤神经平面可识别慢性SCI人群中动脉僵硬度升高的高危患者。