Department of Cardiology, Shanghai Tenth People's Hospital, Tongji University School of Medicine, Shanghai, China.
AP-HP; Diagnosis and Therapeutic Center, Paris Descartes University; HôtelDieu, Paris, France.
Hypertens Res. 2018 May;41(5):372-381. doi: 10.1038/s41440-018-0027-3. Epub 2018 Mar 13.
This study aimed to investigate the discrepancy between pulse wave velocity (PWV) and pulse pressure amplification (PPA) in association with hypertensive target organ damage (TOD) in the elderly. From June 2014 to August 2015, 1599 participants aged >65 years old from communities located in northern Shanghai were recruited. Carotid-femoral pulse wave velocity (cfPWV), peripheral blood pressure (BP), central BP and other TOD indicators, including the ratio of the early ventricular filling velocity (E) to the peak velocity of the tissue Doppler velocity of septal mitral annulus (E/Ea), left ventricular mass index (LVMI), carotid intima-medium thickness (CIMT), estimated glomerular filtration rate (eGFR), and urinary albumin-creatinine ratio (ACR), were determined for each participant. PPA was defined as the peripheral-to-central pulse pressure ratio. In multivariable linear regression analysis, cfPWV was significantly associated with CIMT (β = 12.83 ± 4.28 μm per SD; P = 0.003) and eGFR (β = -1.85 ± 0.69 ml/min/1.73 m per SD; P = 0.007), whereas PPA was significantly associated with E/Ea (β = -0.25 ± 0.10 per SD; P = 0.01) and LVMI (β = -3.00 ± 0.78 g/m per SD; P < 0.001). Similarly, in multivariable logistic regression analysis, cfPWV was significantly associated with arterial plaque (odds ratio [OR], 1.21 [95% confidence interval [CI], 1.05-1.39]; P = 0.007), peripheral artery disease (OR, 1.22 [95% CI, 1.06-1.42]; P = 0.007), chronic kidney diseases (OR, 1.24 [95% CI, 1.01-1.54]; P = 0.04) and microalbuminuria (OR, 1.21 [95% CI, 1.07-1.37]; P = 0.002), while PPA was tightly associated with left ventricular hypertrophy (OR, 0.85 [95% CI, 0.72-0.99]; P = 0.04) and diastolic dysfunction (OR, 0.78 [95% CI, 0.64-0.96]; P = 0.02). In conclusion, cfPWV is a vessel-related and renal-related biomarker, while PPA is a cardiac-related biomarker in community-based elderly.
本研究旨在探讨老年人脉波速度（PWV）与脉搏压力放大（PPA）与高血压靶器官损伤（TOD）之间的差异。2014 年 6 月至 2015 年 8 月，从位于上海北部社区的 1599 名年龄>65 岁的参与者中招募了本研究。测量了每位参与者的颈动脉-股动脉脉搏波速度（cfPWV）、外周血压（BP）、中心血压和其他 TOD 指标，包括早期心室充盈速度（E）与间隔二尖瓣环组织多普勒速度峰值的比值（E/Ea）、左心室质量指数（LVMI）、颈动脉内膜中层厚度（CIMT）、估算肾小球滤过率（eGFR）和尿白蛋白-肌酐比（ACR）。PPA 定义为外周与中心脉搏压比。多变量线性回归分析显示，cfPWV 与 CIMT（β=12.83±4.28μm/每 SD；P=0.003）和 eGFR（β=-1.85±0.69ml/min/每 1.73m2/SD；P=0.007）显著相关，而 PPA 与 E/Ea（β=-0.25±0.10/每 SD；P=0.01）和 LVMI（β=-3.00±0.78g/m/每 SD；P<0.001）显著相关。同样，在多变量逻辑回归分析中，cfPWV 与动脉斑块（比值比[OR]，1.21[95%置信区间[CI]，1.05-1.39]；P=0.007）、外周动脉疾病（OR，1.22[95%CI，1.06-1.42]；P=0.007）、慢性肾脏病（OR，1.24[95%CI，1.01-1.54]；P=0.04）和微量白蛋白尿（OR，1.21[95%CI，1.07-1.37]；P=0.002）显著相关，而 PPA 与左心室肥厚（OR，0.85[95%CI，0.72-0.99]；P=0.04）和舒张功能障碍（OR，0.78[95%CI，0.64-0.96]；P=0.02）密切相关。总之，cfPWV 是一种与血管和肾脏相关的生物标志物，而 PPA 是一种与心脏相关的社区老年人生物标志物。
