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磁共振成像评估的主动脉弓脉搏波速度作为心血管事件发生的预测指标:动脉粥样硬化多族裔研究(MESA)

Aortic Arch Pulse Wave Velocity Assessed by Magnetic Resonance Imaging as a Predictor of Incident Cardiovascular Events: The MESA (Multi-Ethnic Study of Atherosclerosis).

作者信息

Ohyama Yoshiaki, Ambale-Venkatesh Bharath, Noda Chikara, Kim Jang-Young, Tanami Yutaka, Teixido-Tura Gisela, Chugh Atul R, Redheuil Alban, Liu Chia-Ying, Wu Colin O, Hundley W Gregory, Bluemke David A, Guallar Eliseo, Lima Joao A C

机构信息

From the Department of Cardiology (Y.O., C.N., J.-Y.K., Y.T., G.T.-T., A.R.C., J.A.C.L.), Department of Radiology (B.A.-V.), and Department of Epidemiology (E.G.), Johns Hopkins University, Baltimore, MD; Imagerie Cardiovasculaire/Department of Cardiovascular Imaging DICVRI, Institut de Cardiologie, Groupe Hospitalier Pitié Salpêtrière, Paris (A.R.); Radiology and Imaging Sciences, National Institutes of Health Clinical Center, Bethesda, MD (C.-Y.L., D.A.B.); Office of Biostatistics Research, National Heart, Lung, and Blood Institute, Bethesda, MD (C.O.W.); and Department of Epidemiology and Prevention, Wake Forest School of Medicine, Winston-Salem, NC (W.G.H.).

出版信息

Hypertension. 2017 Sep;70(3):524-530. doi: 10.1161/HYPERTENSIONAHA.116.08749. Epub 2017 Jul 3.

Abstract

The predictive value of aortic arch pulse wave velocity (PWV) assessed by magnetic resonance imaging for cardiovascular disease (CVD) events has not been fully established. The aim of the present study was to evaluate the association of arch PWV with incident CVD events in MESA (Multi-Ethnic Study of Atherosclerosis). Aortic arch PWV was measured using magnetic resonance imaging at baseline in 3527 MESA participants (mean age, 62±10 years at baseline; 47% men) free of overt CVD. Cox regression was used to evaluate the risk of incident CVD (coronary heart disease, stroke, transient ischemic attack, or heart failure) in relation to arch PWV adjusted for age, sex, race, and CVD risk factors. The median value of arch PWV was 7.4 m/s (interquartile range, 5.6-10.2). There was significant interaction between arch PWV and age for outcomes, so analysis was stratified by age categories (45-54 and >54 years). There were 456 CVD events during the 10-year follow-up. Forty-five to 54-year-old participants had significant association of arch PWV with incident CVD independent of CVD risk factors (hazard ratio, 1.44; 95% confidence interval, 1.07-1.95; =0.018; per 1-SD increase for logarithmically transformed PWV), whereas >54-year group did not (=0.93). Aortic arch PWV assessed by magnetic resonance imaging is a significant predictor of CVD events among middle-aged (45-54 years old) individuals, whereas arch PWV is not associated with CVD among an elderly in a large multiethnic population.

摘要

通过磁共振成像评估的主动脉弓脉搏波速度(PWV)对心血管疾病(CVD)事件的预测价值尚未完全确立。本研究的目的是评估多民族动脉粥样硬化研究(MESA)中主动脉弓PWV与CVD事件发生的相关性。在3527名无明显CVD的MESA参与者(基线时平均年龄62±10岁;47%为男性)中,于基线时使用磁共振成像测量主动脉弓PWV。采用Cox回归评估与经年龄、性别、种族和CVD危险因素调整后的主动脉弓PWV相关的CVD(冠心病、中风、短暂性脑缺血发作或心力衰竭)发生风险。主动脉弓PWV的中位数为7.4米/秒(四分位间距,5.6 - 10.2)。主动脉弓PWV与年龄在结局方面存在显著交互作用,因此按年龄类别(45 - 54岁和>54岁)进行分层分析。在10年随访期间有456例CVD事件。45至54岁的参与者中,主动脉弓PWV与CVD事件发生存在显著相关性,且独立于CVD危险因素(风险比,1.44;95%置信区间,1.07 - 1.95;P = 0.018;对数转换后的PWV每增加1个标准差),而>54岁组则无相关性(P = 0.93)。通过磁共振成像评估的主动脉弓PWV是中年(45 - 54岁)个体中CVD事件的重要预测指标,而在一个大型多民族人群中,老年人群的主动脉弓PWV与CVD无相关性。

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