Finnish Cardiovascular Research Center - Tampere, Arvo Ylpön Katu 34 (33520 Tampere), P.O. Box 100, FI-33014 Tampere University, Finland; Faculty of Medicine and Health Technology, Arvo Ylpön Katu 34 (33520 Tampere) P.O. Box 100, FI-33014 Tampere University, Finland.
Finnish Cardiovascular Research Center - Tampere, Arvo Ylpön Katu 34 (33520 Tampere), P.O. Box 100, FI-33014 Tampere University, Finland; Faculty of Medicine and Health Technology, Arvo Ylpön Katu 34 (33520 Tampere) P.O. Box 100, FI-33014 Tampere University, Finland; Department of Clinical Chemistry, Fimlab Laboratories, Arvo Ylpön Katu 34 (33520 Tampere), P.O. Box 100, FI-33014 Tampere University, Finland; Department of Cardiology, Heart Center, Tampere University Hospital, Elämänaukio 1, 33520, Tampere, Finland.
Atherosclerosis. 2021 Feb;319:101-107. doi: 10.1016/j.atherosclerosis.2021.01.006. Epub 2021 Jan 12.
The aim of this study was to examine an association of individual and combined pulse waveform parameters derived from bioimpedance measurements, that is pulse waves from a distal impedance plethysmographic (IPG), a whole-body impedance cardiographic (ICG) and transformed distal impedance plethysmographic (tIPG) signals, with markers of subclinical atherosclerosis, i.e. carotid intima-media thickness (cIMT), brachial artery flow-mediated dilation (FMD) and carotid artery distensibility (Cdist). The level of the association was also compared for arterial pulse wave velocity (PWV) and cIMT, FMD, and Cdist.
IPG, ICG, tIPG signals were measured from 1741 Finnish adults aged 30-45 years. The association between pulse wave parameters and cIMT, FMD and Cdist was studied using bootstrapped stepwise Akaike's Information Criterion method resulting in selection of parameters other than PWV, i.e. parameters having stronger association with cIMT, FMD and Cdist than PWV, in the model. Then risk scores were calculated from the selected pulse wave parameters and their association between cIMT, FMD and Cdist was studied with multivariable linear regression analysis.
The risk score was found to be the third strongest predictor of subclinical atherosclerosis as indicated by cIMT measurement, the second strongest predictor of FMD and the strongest predictor of Cdist. These findings show that several individual pulse wave parameters were associated more strongly with cIMT, FMD, and Cdist than PWV when adjusted with clinical risk factors.
Impedance based pulse waveform analysis provides a useful tool for assessing cardiovascular risk and estimating presence of structural changes in the vasculature.
本研究旨在探讨个体和联合脉搏波参数与亚临床动脉粥样硬化标志物的相关性，这些参数来源于生物阻抗测量，包括远端阻抗容积描记（IPG）、全身阻抗心动描记（ICG）和转换后的远端阻抗容积描记（tIPG）信号，与亚临床动脉粥样硬化标志物，即颈动脉内膜中层厚度（cIMT）、肱动脉血流介导的扩张（FMD）和颈动脉顺应性（Cdist）相关。还比较了动脉脉搏波速度（PWV）与 cIMT、FMD 和 Cdist 的相关性。
从 1741 名年龄在 30-45 岁的芬兰成年人中测量了 IPG、ICG、tIPG 信号。使用 Bootstrap 逐步 Akaike 信息准则（Akaike's Information Criterion，AIC）方法研究脉搏波参数与 cIMT、FMD 和 Cdist 的相关性，该方法可从模型中选择除 PWV 以外的参数，即与 cIMT、FMD 和 Cdist 的相关性强于 PWV 的参数。然后，从选定的脉搏波参数计算风险评分，并使用多变量线性回归分析研究其与 cIMT、FMD 和 Cdist 的相关性。
结果表明，风险评分是 cIMT 测量所指示的亚临床动脉粥样硬化的第三大最强预测因子，是 FMD 的第二大最强预测因子，也是 Cdist 的最强预测因子。这些发现表明，在调整临床危险因素后，与 PWV 相比，几个个体脉搏波参数与 cIMT、FMD 和 Cdist 的相关性更强。
基于阻抗的脉搏波分析为评估心血管风险和估计血管结构变化提供了有用的工具。
