Murata Naotaka, Shiina Kazuki, Yamashita Jun, Tanaka Nobuhiro, Chikamori Taishiro, Yamashina Akira, Tomiyama Hirofumi
Department of Cardiology, Tokyo Medical University, Tokyo, Japan.
Pulse (Basel). 2018 Mar;5(1-4):154-160. doi: 10.1159/000486162. Epub 2018 Feb 6.
Recently, a simple parameter calculated from the brachial pressure waveform recorded using an oscillometric device (arterial velocity pulse index [AVI]: ratio of the forward/reflected pressure wave amplitudes) has become available to assess the pathophysiological abnormalities associated with vascular damage. Peripheral artery disease (PAD) represents one of the disease entities associated with the advanced stages of atherosclerotic vascular damage. The present study was conducted to examine whether an increase in the AVI might be influenced by the presence of PAD.
The AVI was measured from oscillometric recordings of the brachial pressure waveform, and the ankle-brachial pressure index (ABPI) was determined by an oscillometric method. Study 1: In 341 consecutive patients admitted for the management of cardiovascular disease and/or cardiovascular risk factors, the ABPI and the AVI were measured simultaneously. An ABPI ≤0.90 was observed in 19 subjects, and logistic regression analysis revealed a significant association between AVI and ABPI ≤0.90 (odds ratio = 1.81; 95% confidence interval = 1.15-2.84; = 0.01). Study 2: In another 19 patients with PAD, percutaneous transluminal angioplasty resulted in a decrease in the AVI from 31 ± 8 to 27 ± 8 ( < 0.01).
Possible presence of PAD must be taken into account while applying the AVI for the assessment of vascular damage.
最近,一种根据示波装置记录的肱动脉压力波形计算得出的简单参数(动脉速度脉搏指数[AVI]:正向/反射压力波振幅之比)已可用于评估与血管损伤相关的病理生理异常。外周动脉疾病(PAD)是与动脉粥样硬化性血管损伤晚期相关的疾病实体之一。本研究旨在探讨AVI升高是否可能受PAD存在的影响。
通过示波记录肱动脉压力波形测量AVI,并采用示波法测定踝臂压力指数(ABPI)。研究1:在341例因心血管疾病和/或心血管危险因素入院治疗的连续患者中,同时测量ABPI和AVI。19名受试者的ABPI≤0.90,逻辑回归分析显示AVI与ABPI≤0.90之间存在显著关联(比值比=1.81;95%置信区间=1.15 - 2.84;P = 0.01)。研究2:在另外19例PAD患者中,经皮腔内血管成形术使AVI从31±8降至27±8(P<0.01)。
在应用AVI评估血管损伤时,必须考虑PAD的可能存在。