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动脉僵硬度(通过监测 Qkd 间期得出)可预测心血管事件和总死亡率的发生。

Arterial stiffness (from monitoring of Qkd interval) predict the occurrence of cardiovascular events and total mortality.

机构信息

Hypertension unit, University hospital of Bordeaux, Bordeaux, France.

出版信息

J Hum Hypertens. 2023 Oct;37(10):907-912. doi: 10.1038/s41371-022-00797-4. Epub 2022 Dec 29.

Abstract

Arterial stiffness, most often assessed with carotido-femoral pulse wave velocity predicts cardiovascular events but its use in clinical practice remains limited. The 24 h ambulatory monitoring of Blood pressure and timing of Korotkoff sounds (QKD interval) allows an automatic assessment of arterial stiffness and is an independent predictor of cardiovascular events in hypertensive patients. The long term follow up of our cohort of hypertensive patients gave us the opportunity to test the consequences of increased arterial stiffness on the incidence of all causes deaths and to define the populations who could benefit of this measurement beyond risk scores. The sample includes 930 patients (502 males, age 53 ± 13 years, baseline risk SCORE2-OP = 6.70 ± 4.97%) with an average follow up of 12.11 ± 7.4 years (0.3-30). In this population 169 cardiovascular events and 155 deaths were recorded. SCORE2-OP, 24 h Systolic Blood Pressure and arterial stiffness (QKDh) as a continuous or discontinuous variable (normal or reduced) were significantly and independently linked to the occurrence of cardiovascular events or all cause deaths in multivariate Cox model. ROC curves analysis show that measuring arterial stiffness with QKD method offers the best predictive value in patients with low or very low risk scores.

摘要

动脉僵硬度,通常通过颈股脉搏波速度评估,可预测心血管事件,但在临床实践中的应用仍然有限。24 小时动态血压监测和柯氏音(QKD 间期)的时间可以自动评估动脉僵硬度,并且是高血压患者心血管事件的独立预测因素。对我们高血压患者队列的长期随访使我们有机会检验动脉僵硬度增加对全因死亡率发生率的影响,并确定哪些人群可以从这种测量方法中获益,而不仅仅是基于风险评分。该样本包括 930 名患者(502 名男性,年龄 53±13 岁,基线风险 SCORE2-OP=6.70±4.97%),平均随访时间为 12.11±7.4 年(0.3-30)。在该人群中,记录了 169 例心血管事件和 155 例死亡。多变量 Cox 模型显示,SCORE2-OP、24 小时收缩压和动脉僵硬度(QKDh)作为连续或不连续变量(正常或降低)与心血管事件或全因死亡的发生显著相关。ROC 曲线分析表明,在低风险评分或极低风险评分的患者中,使用 QKD 方法测量动脉僵硬度具有最佳的预测价值。

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