Qiao Li-Jie, Qi Zhen, Tu Li-Ping, Zhang Yu-Hang, Zhu Li-Ping, Xu Jia-Tuo, Zhang Zhi-Feng
Basic Medical College, Shanghai University of Traditional Chinese Medicine, 1200 Cailun Road, Shanghai 201203, China.
Ultrasonic Diagnosis Department, The First People's Hospital of Taicang Affiliated to Suzhou University, 58 South Changsheng Road, Taicang 215400, China.
Evid Based Complement Alternat Med. 2018 Dec 2;2018:5291759. doi: 10.1155/2018/5291759. eCollection 2018.
This study aims at exploring the cardiovascular pathophysiological mechanism of TCM (traditional Chinese medicine) pulse by detecting the correlation between radial artery pulse wave variables and pulse wave velocity/echocardiographic parameters. Two hundred Chinese subjects were enrolled in this study, which were grouped into health control group, hypertension group, and hypertensive heart disease group. Physical data obtained in this study contained TCM pulse images at "Guan" position of the left hand, pulse wave velocity, and echocardiographic parameters. Linear and stepwise regression analysis was performed to assess the association of radial artery pulse wave variables with pulse wave velocity and echocardiographic parameters in the total population and in each different group. After adjusting for related confounding factors, decrease of t, t and increase of h, h/h were statistically associated with arterial stiffness in the total population (P<0.05). Moreover, the correlation study in each group showed that the decrease of both t and h was also related to arterial stiffness (P<0.05). In terms of echocardiographic parameters, the height of dicrotic wave indicated by h was the most relevant pulse wave variable. For the health control, h was negatively associated with interventricular septal thickness (VST) and left ventricular posterior wall thickness (PWT) (P<0.05), while for the hypertension population and those with target-organ damage to heart, increase of h might be associated with decrease of ejection fraction (EF) and increase of all the remaining echocardiographic parameters especially for left ventricular end-systolic diameter (LVDs) and Left ventricular end-diastolic diameter (LVDd) (P<0.05). In conclusion, we found radial artery pulse wave variables were in association with the arterial stiffness and echocardiographic changes in hypertension, which would provide an experimental basis for cardiovascular pathophysiological mechanism of radial artery pulse wave variables.
本研究旨在通过检测桡动脉脉搏波变量与脉搏波速度/超声心动图参数之间的相关性，探索中医脉象的心血管病理生理机制。本研究纳入了200名中国受试者，分为健康对照组、高血压组和高血压性心脏病组。本研究获得的身体数据包括左手“关”位的中医脉象图像、脉搏波速度和超声心动图参数。进行线性和逐步回归分析，以评估总人群和各不同组中桡动脉脉搏波变量与脉搏波速度和超声心动图参数之间的关联。在调整相关混杂因素后，总人群中t、t的降低以及h、h/h的升高与动脉僵硬度具有统计学相关性（P<0.05）。此外，每组的相关性研究表明，t和h的降低也与动脉僵硬度相关（P<0.05）。就超声心动图参数而言，h所指示的重搏波高度是最相关的脉搏波变量。对于健康对照组，h与室间隔厚度（VST）和左心室后壁厚度（PWT）呈负相关（P<0.05），而对于高血压人群和心脏靶器官损害者，h的升高可能与射血分数（EF）降低以及所有其余超声心动图参数升高有关，尤其是左心室收缩末期内径（LVDs）和左心室舒张末期内径（LVDd）（P<0.05）。总之，我们发现桡动脉脉搏波变量与高血压患者的动脉僵硬度和超声心动图变化相关，这将为桡动脉脉搏波变量的心血管病理生理机制提供实验依据。
