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成人先天性心脏病患者的早期血管衰老。

Early vascular aging in adult patients with congenital heart disease.

机构信息

Department of Pediatrics, Sapporo Tokushukai Hospital, Sapporo, Japan.

Department of Adult Congenital Heart Disease, Chiba Cardiovascular Center, Ichihara, Japan.

出版信息

Hypertens Res. 2021 Sep;44(9):1122-1128. doi: 10.1038/s41440-021-00658-6. Epub 2021 Apr 15.

Abstract

Many studies have reported that adults with congenital heart disease suffer from hypertension and cardiovascular disease even at younger ages. Therefore, we analyzed early vascular aging, which is defined as pulse wave velocity values higher than the 95th percentile for age and sex, and clarified the relationship between early vascular aging and many parameters related to cardiovascular disorders in adults with congenital heart disease. We enrolled 72 adult patients with congenital heart disease and measured their brachial-ankle pulse wave velocity. Comparing the data between age- and sex-matched controls, patients with a pulse wave velocity higher than the 95th percentile for age and sex were defined as exhibiting early vascular aging. The parameters of patients with and without early vascular aging were compared. Early vascular aging was observed in 15.6% of the patients. Age, systolic blood pressure, diastolic blood pressure, pulse pressure, blood sugar, hemoglobin A1c, uric acid, low-density lipoprotein cholesterol, and triglyceride levels were positive determinants of early vascular aging. Logistic regression analysis proved that systolic blood pressure was a significant determinant of early vascular aging (odds ratio, 1.128, 95% confidence interval, 1.049-1.214; p = 0.001). The prevalence of early vascular aging is high in adult patients with congenital heart disease. Because early vascular aging can damage a patient's vulnerable heart, careful follow-up of blood pressure and pulse wave velocity is essential.

摘要

许多研究报告指出,患有先天性心脏病的成年人即使在年轻时也会患上高血压和心血管疾病。因此,我们分析了早期血管老化,即脉搏波速度值高于年龄和性别第 95 百分位数,并阐明了先天性心脏病成年人的早期血管老化与许多与心血管疾病相关的参数之间的关系。我们招募了 72 名患有先天性心脏病的成年患者,并测量了他们的肱踝脉搏波速度。将患者数据与年龄和性别匹配的对照组进行比较,将脉搏波速度高于年龄和性别第 95 百分位数的患者定义为存在早期血管老化。比较了存在和不存在早期血管老化的患者的参数。在 15.6%的患者中观察到早期血管老化。年龄、收缩压、舒张压、脉压、血糖、糖化血红蛋白、尿酸、低密度脂蛋白胆固醇和甘油三酯水平是早期血管老化的正相关决定因素。逻辑回归分析证明,收缩压是早期血管老化的显著决定因素(比值比,1.128;95%置信区间,1.049-1.214;p=0.001)。患有先天性心脏病的成年患者中早期血管老化的患病率较高。因为早期血管老化会损害患者脆弱的心脏,所以对血压和脉搏波速度进行仔细的随访至关重要。

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