Pol Arch Intern Med. 2018 Apr 30;128(4):228-234. doi: 10.20452/pamw.4222. Epub 2018 Mar 9.
INTRODUCTION The excess pressure-time integral (excess PTI) and reservoir pressure-time integral(reservoir PTI) are new measures derived from blood pressure (BP) waveform decomposition. Thesemarkers predict cardiovascular (CV) complications and are associated with target organ damage inpa tients on antihypertensive treatment or those with chronic and acute heart failure. OBJECTIVES We investigated whether reservoir PTI or excess PTI predict future CV events (death, stroke, myocardial infarction [MI]) in patients with acute coronary syndrome (ACS) and reduced ejection fraction (EF). PATIENTS AND METHODS BP waveforms were obtained by radial tonometry in 251 patients with ACS (median age, 64 years) and reduced EF (median, 40%). Left ventricular EF was assessed by transthoracic echocardiography. Reservoir PTI and excess PTI were derived by decomposition of the BP waveform RESULTS A total of 78 CV events occurred during the follow‑up (median, 1245 days). A Kaplan-Meier analysis showed that the highest tertile of excess PTI was a significant predictor of adverse outcome. A multivariate Cox regression analysis demonstrated that excess PTI was a predictor of CV events after adjustment for EF, age, history of stroke, MI, and coronary artery bypass grafting (hazard ratio, 1.9; 95% confidence interval, 1.1-3.3; P = 0.02). CONCLUSIONS In conclusion, excess PTI, a new measure derived from reservoir-pressure analysis, predicts outcome in survivors of ACS with reduced EF.
简介 超压力时间积分（excess PTI）和储器压力时间积分（reservoir PTI）是从血压（BP）波形分解中得出的新指标。这些标志物可预测心血管（CV）并发症，并与接受降压治疗的患者或患有慢性和急性心力衰竭的患者的靶器官损伤有关。 目的 我们研究了在急性冠状动脉综合征（ACS）和射血分数降低（EF）的患者中，储器 PTI 或超压力时间积分是否可以预测未来的 CV 事件（死亡、中风、心肌梗死[MI]）。 患者和方法 通过桡动脉张力测定法在 251 名 ACS 患者（中位年龄 64 岁）和 EF 降低（中位 EF 40%）中获得 BP 波形。通过经胸超声心动图评估左心室 EF。通过 BP 波形的分解得出储器 PTI 和超压力时间积分 结果 在随访期间（中位时间 1245 天）共发生 78 例 CV 事件。Kaplan-Meier 分析表明，超压力时间积分最高三分位数是不良预后的显著预测因子。多变量 Cox 回归分析表明，在校正 EF、年龄、中风史、MI 和冠状动脉旁路移植术（HR，1.9；95%置信区间，1.1-3.3；P=0.02）后，超压力时间积分是 CV 事件的预测因子。 结论 总之，从储器压力分析中得出的新指标超压力时间积分，可预测射血分数降低的 ACS 幸存者的结局。
