Lu Yuyan, Zhu Mengyun, Bai Bin, Chi Chen, Yu Shikai, Teliewubai Jiadela, Xu Henry, Wang Kai, Xiong Jing, Zhou Yiwu, Ji Hongwei, Fan Ximin, Yu Xuejing, Li Jue, Blacher Jacques, Zhang Yi, Xu Yawei
Department of Cardiology, Shanghai Tenth People's Hospital, Tongji University School of Medicine, Shanghai, China.
Department of Prevention, Tongji University School of Medicine, Shanghai, China.
J Am Heart Assoc. 2017 Feb 20;6(2):e004168. doi: 10.1161/JAHA.116.004168.
Carotid-femoral pulse-wave velocity (cf-PWV) and brachial-ankle PWV (ba-PWV) are the 2 most frequently applied PWV measurements. However, little is known about the comparison of hypertensive target organ damage (TOD) with cf-PWV and ba-PWV.
A total of 1599 community-dwelling elderly subjects (age >65 years) in northern Shanghai were recruited from June 2014 to August 2015. Both cf-PWV and ba-PWV were measured using SphygmoCor and VP1000 systems, respectively. Within the framework of comprehensive cardiovascular examinations, risk factors were assessed, and asymptomatic TOD, including left ventricular mass index, peak transmitral pulsed Doppler velocity/early diastolic tissue Doppler velocity (E/Ea), carotid intima-media thickness, arterial plaque, creatinine clearance rate, and urinary albumin-creatinine ratio were all evaluated. Both PWVs were significantly associated with male sex, age, waist/hip circumference, fasting plasma glucose, and systolic blood pressure, and ba-PWV was also significantly related to body mass index. Both PWVs were significantly correlated with most TOD. When cf-PWV and ba-PWV were both or separately put into the stepwise linear regression model together with cardiovascular risk factors and treatment, only cf-PWV, but not ba-PWV, was significantly associated with carotid intima-media thickness and creatinine clearance rate (<0.05). When cf-PWV and ba-PWV were both or separately put into the same full-mode model after adjustment for confounders, only cf-PWV, but not ba-PWV, showed significant association with carotid intima-media thickness and creatinine clearance rate (<0.05). Similar results were observed in logistic regression analysis.
Taken together, in the community-dwelling elderly Chinese, cf-PWV seems to be more closely associated with hypertensive TOD, especially vascular and renal TOD, as compared with ba-PWV.
URL: http://www.clinicaltrials.gov. Unique identifier: NCT02368938.
颈股脉搏波速度（cf-PWV）和臂踝脉搏波速度（ba-PWV）是最常应用的两种脉搏波速度测量指标。然而，关于cf-PWV和ba-PWV与高血压靶器官损害（TOD）的比较知之甚少。
2014年6月至2015年8月，在上海北部共招募了1599名社区老年受试者（年龄>65岁）。分别使用SphygmoCor和VP1000系统测量cf-PWV和ba-PWV。在全面心血管检查的框架内，评估危险因素，并对无症状TOD进行评估，包括左心室质量指数、二尖瓣峰值脉冲多普勒速度/舒张早期组织多普勒速度（E/Ea）、颈动脉内膜中层厚度、动脉斑块、肌酐清除率和尿白蛋白肌酐比值。两种脉搏波速度均与男性、年龄、腰臀围、空腹血糖和收缩压显著相关，ba-PWV也与体重指数显著相关。两种脉搏波速度均与大多数TOD显著相关。当将cf-PWV和ba-PWV与心血管危险因素及治疗一起纳入逐步线性回归模型时，只有cf-PWV与颈动脉内膜中层厚度和肌酐清除率显著相关（<0.05），而ba-PWV无此相关性。在调整混杂因素后，将cf-PWV和ba-PWV一起或分别纳入同一全模型时，只有cf-PWV与颈动脉内膜中层厚度和肌酐清除率显著相关（<0.05），ba-PWV无此相关性。在逻辑回归分析中也观察到类似结果。
总体而言，在社区居住的中国老年人中，与ba-PWV相比，cf-PWV似乎与高血压TOD，尤其是血管和肾脏TOD的关系更为密切。
