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动脉僵硬度是一种与动脉扩张相关的遗传性特征,但与管壁增厚无关:双胞胎英国队列的纵向研究。

Arterial stiffening is a heritable trait associated with arterial dilation but not wall thickening: a longitudinal study in the twins UK cohort.

机构信息

Department of Clinical Pharmacology, King's College London British Heart Foundation Centre, St Thomas' Hospital, Lambeth Palace Road, London, UK.

Division of Cardiology, Department of Pediatrics, UT Southwestern Medical Center, 1935 Medical District Drive B3.09, Dallas, TX, USA.

出版信息

Eur Heart J. 2018 Jun 21;39(24):2282-2288. doi: 10.1093/eurheartj/ehy165.

Abstract

AIMS

Vascular ageing is characterized by arterial stiffening, dilation, and arterial wall thickening. We investigated the extent to which these changes are related and their heritability during 5 year follow-up in the Twins UK cohort.

METHODS AND RESULTS

Carotid-femoral pulse wave velocity (PWVcf), carotid diameter, carotid distensibility, and carotid intima-media thickness (IMT) were measured in 762 female twins (mean age 57.9 ± 8.6 years) at two time-points over an average follow-up of 4.9 ± 1.5 years. Magnetic resonance imaging (MRI) was performed in a sub-sample of 38 women to measure aortic pulse wave velocity (PWVaorta), diameter, and wall thickness. Heritability of changes in arterial wall properties was estimated using structural equation modelling. Annual increases in PWVcf, carotid diameter, distensibility, and IMT were 0.139 m/s, 0.028 mm, -0.4 kPa-1, and 0.011 mm per year, respectively. In regression analysis, predictors of progression in PWVcf included age, mean arterial pressure (MAP), and heart rate (HR) at baseline, and progression in MAP, HR, and body mass index (BMI). Predictors of progression in IMT included progression in MAP, BMI, and triglyceride levels. Progression of PWV and distensibility correlated with progression in carotid diameter but not with IMT. Heritability of progression of PWVcf, diameter, and IMT was 55%, 21%, and 8%, respectively. In a sub-sample of women that underwent MRI, aortic wall thickness increased by 0.19 mm/year, but aortic wall thickening was not correlated with an increase in lumen diameter or PWVaorta.

CONCLUSION

Arterial stiffening, as measured by PWVcf, and dilation are heritable but independent of arterial wall thickening. Genetic and cardiovascular risk factors contribute differently to progression of PWV and IMT.

摘要

目的

血管老化的特征是动脉僵硬、扩张和动脉壁增厚。我们在英国双胞胎队列中进行了为期 5 年的随访研究,旨在探讨这些变化在多大程度上相关及其遗传性。

方法和结果

在两次随访中,共测量了 762 名女性双胞胎(平均年龄 57.9±8.6 岁)的颈股脉搏波速度(PWVcf)、颈动脉直径、颈动脉扩张性和颈动脉内膜中层厚度(IMT),平均随访时间为 4.9±1.5 年。在 38 名女性亚组中进行了磁共振成像(MRI)检查,以测量主动脉脉搏波速度(PWVaorta)、直径和壁厚度。使用结构方程模型估计动脉壁性质变化的遗传率。PWVcf、颈动脉直径、扩张性和 IMT 的年增长率分别为 0.139m/s、0.028mm、-0.4kPa-1和 0.011mm/年。在回归分析中,PWVcf 进展的预测因子包括基线时的年龄、平均动脉压(MAP)和心率(HR),以及 MAP、HR 和体重指数(BMI)的进展。IMT 进展的预测因子包括 MAP、BMI 和甘油三酯水平的进展。PWV 和扩张性的进展与颈动脉直径的进展相关,但与 IMT 无关。PWVcf、直径和 IMT 进展的遗传率分别为 55%、21%和 8%。在接受 MRI 的女性亚组中,主动脉壁厚度每年增加 0.19mm,但主动脉壁增厚与管腔直径或 PWVaorta 的增加无关。

结论

PWVcf 测量的动脉僵硬和扩张是可遗传的,但与动脉壁增厚无关。遗传和心血管危险因素对 PWV 和 IMT 的进展有不同的贡献。

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