Tan Isabella, Butlin Mark, Spronck Bart, Xiao Hanguang, Avolio Alberto
Department of Biomedical Sciences, Faculty of Medicine and Health Sciences, Macquarie University, Sydney, Australia.
Chongqing Key Laboratory of Modern Photoelectric Detection Technology and Instrument, School of Optoelectronic Information, Chongqing University of Technology, Chongqing, China.
Curr Hypertens Rev. 2018;14(2):107-122. doi: 10.2174/1573402113666170724100418.
Vascular assessment is becoming increasingly important in the diagnosis of cardiovascular diseases. In particular, clinical assessment of arterial stiffness, as measured by pulse wave velocity (PWV), is gaining increased interest due to the recognition of PWV as an influential factor on the prognosis of hypertension as well as being an independent predictor of cardiovascular and all-cause mortality. Whilst age and blood pressure are established as the two major determinants of PWV, the influence of heart rate on PWV measurements remains controversial with conflicting results being observed in both acute and epidemiological studies. In a majority of studies investigating the acute effects of heart rate on PWV, results were confounded by concomitant changes in blood pressure. Observations from epidemiological studies have also failed to converge, with approximately just half of such studies reporting a significant blood-pressure-independent association between heart rate and PWV. Further to the lack of consensus on the effects of heart rate on PWV, the possible mechanisms contributing to observed PWV changes with heart rate have yet to be fully elucidated, although many investigators have attributed heart-rate related changes in arterial stiffness to the viscoelasticity of the arterial wall. With elevated heart rate being an independent prognostic factor of cardiovascular disease and its association with hypertension, the interaction between heart rate and PWV continues to be relevant in assessing cardiovascular risk.
血管评估在心血管疾病的诊断中变得越来越重要。特别是，通过脉搏波速度（PWV）测量的动脉僵硬度的临床评估越来越受到关注，因为人们认识到PWV是影响高血压预后的一个因素，也是心血管和全因死亡率的独立预测指标。虽然年龄和血压是PWV的两个主要决定因素，但心率对PWV测量的影响仍存在争议，在急性研究和流行病学研究中都观察到了相互矛盾的结果。在大多数研究心率对PWV急性影响的研究中，结果因血压的同时变化而混淆。流行病学研究的观察结果也未能达成一致，大约只有一半的此类研究报告心率与PWV之间存在显著的独立于血压的关联。除了对心率对PWV的影响缺乏共识外，尽管许多研究人员将与心率相关的动脉僵硬度变化归因于动脉壁的粘弹性，但导致观察到的PWV随心率变化的可能机制尚未完全阐明。由于心率升高是心血管疾病的独立预后因素及其与高血压的关联，心率与PWV之间的相互作用在评估心血管风险方面仍然具有相关性。
