Division of Nephrology.
Division of Vascular Medicine, Department of Internal Medicine.
J Hypertens. 2020 Jun;38(6):1064-1071. doi: 10.1097/HJH.0000000000002390.
Arterial stiffness influences the contour of the digital pressure pulse wave.
Here, we investigated whether the digital pulse propagation index (DPPI), based on the digital pressure pulse wave, DPPI is associated with cardiovascular events, heart failure, and mortality in a large population-based cohort. Between 2001 and 2003, DPPI was measured with a PortaPres noninvasive hemodynamic monitoring device (FinaPres Medical Systems, Amsterdam, The Netherlands) in participants of the Prevention of Renal and Vascular End-stage Disease study, a community-based cohort. We assessed the main determinants of the DPPI and investigated associations of DPPI with cardiovascular events and mortality.
The study included 5474 individuals. Mean age was 52.3 ± 11.8 years and 50.5% was male. Median baseline DPPI was 5.81 m/s (interquartile range 5.47-6.20). Higher age, mean arterial blood pressure, body height, heart rate, current smoking, and lower HDL cholesterol levels and waist circumference were independent determinants of the DPPI (r = 0.43). After adjustment for heart rate, highlogDPPI was associated with all-cause mortality [hazard ratio: 1.67, 95% confidence interval (1.55-1.81) per SD; P < 0.001], cardiovascular mortality [hazard ratio 1.95 (1.72-2.22); P < 0.001], and incident heart failure with reduced ejection fraction [hazard ratio 1.81 (1.60-2.06); P < 0.001]. These associations remained independent upon further adjustment for confounders. Optimal cutoff values for DPPI ranged between 6.1 and 6.3 m/s for all endpoints. After multivariable adjustment, DPPI was no longer associated with coronary artery disease events or cerebrovascular events.
The DPPI is associated with an increased risk of development of new onset heart failure with reduced ejection fraction and all-cause and cardiovascular mortality, but not with coronary artery events or cerebrovascular events.
动脉僵硬度会影响数字脉搏压力波的形态。
本研究旨在探讨基于数字脉搏压力波的数字脉搏传播指数（DPPI）是否与心血管事件、心力衰竭和死亡率相关。在一项基于人群的大型队列研究中，于 2001 年至 2003 年期间，使用 PortaPres 无创血流动力学监测仪（荷兰阿姆斯特丹 FinaPres 医疗系统公司）测量了预防肾脏和血管终末期疾病研究参与者的 DPPI。我们评估了 DPPI 的主要决定因素，并研究了 DPPI 与心血管事件和死亡率的关系。
该研究纳入了 5474 名个体。平均年龄为 52.3±11.8 岁，50.5%为男性。基线 DPPI 的中位数为 5.81m/s（四分位间距 5.47-6.20）。更高的年龄、平均动脉压、身高、心率、当前吸烟状态以及更低的高密度脂蛋白胆固醇水平和腰围是 DPPI 的独立决定因素（r=0.43）。在调整心率后，高 DPPI 与全因死亡率[风险比：1.67，95%置信区间（1.55-1.81）/SD；P<0.001]、心血管死亡率[风险比 1.95（1.72-2.22）；P<0.001]和射血分数降低的新发心力衰竭[风险比 1.81（1.60-2.06）；P<0.001]相关。这些相关性在进一步调整混杂因素后仍然存在。DPPI 的最佳截断值范围为 6.1 至 6.3 m/s，适用于所有终点。经过多变量调整后，DPPI 与冠状动脉疾病事件或脑血管事件不再相关。
DPPI 与新发射血分数降低的心力衰竭以及全因和心血管死亡率的风险增加相关，但与冠状动脉事件或脑血管事件无关。
