University of Wisconsin School of Medicine and Public Health.
William S. Middleton Memorial Veteran's Hospital, Madison, Wisconsin.
J Hypertens. 2023 Mar 1;41(3):486-493. doi: 10.1097/HJH.0000000000003365. Epub 2023 Jan 12.
A wide variety of different formulae have been used to calculate local arterial stiffness with little external validation in relationship to cardiovascular events. We compared the associations of several arterial stiffness calculations in a large, multiethnic cohort.
The multi-ethnic study of atherosclerosis (MESA) is a longitudinal study of 6814 adults without clinical cardiovascular disease (CVD) at enrollment. MESA participants with CVD surveillance through year 2018 and carotid ultrasound ( n = 5873) or aorta MRI ( n = 3175) at the baseline exam (2000-2002) were included. We analyzed 21 different calculations of local arterial stiffness. Cross-sectional and longitudinal statistical analyses were performed in addition to Cox hazard modeling for associations with CVD events (myocardial infarction, resuscitated cardiac arrest, stroke, adjudicated angina, and cardiovascular death).
Carotid artery stiffness calculations had variable correlations with each other ( r = 0.56-0.99); aortic stiffness measures were similar ( r = 0.66-0.99). Nevertheless, for CVD events, the hazard ratio (HR) per standard deviation change were similar for all carotid stiffness calculations with HRs in the range of 1.00-1.10 (equivalence P < 0.001). For the aorta, aortic distensibility coefficient had a stronger association with CVD events (HR 1.18 [1.02-1.37]) compared to aorta Peterson's elastic modulus (HR 0.98 [0.89-1.07]) and aorta pulse wave velocity (HR 1.00 [0.90-1.11]). HRs between all other aortic stiffness calculations were equivalent ( P < 0.01).
Different methods of calculating local arterial stiffness largely gave equivalent results, indicating that the variety of different arterial stiffness calculations in use do not cause inconsistent findings.
已有多种不同的公式被用于计算局部动脉僵硬度，但与心血管事件的关系尚未得到外部验证。我们比较了大型多民族队列中几种动脉僵硬度计算方法的相关性。
动脉粥样硬化多民族研究（MESA）是一项无临床心血管疾病（CVD）的 6814 名成年人的纵向研究。在基线检查（2000-2002 年）时，对有 CVD 监测的 MESA 参与者（n=5873）进行颈动脉超声或主动脉 MRI，或对有 CVD 监测的参与者（n=3175）进行主动脉 MRI，对其进行分析。我们分析了 21 种局部动脉僵硬度的不同计算方法。除了 Cox 风险模型评估与 CVD 事件（心肌梗死、复苏性心脏骤停、卒中等）的相关性外，还进行了横断面和纵向统计分析。
颈动脉僵硬度的计算方法之间的相关性各不相同（r=0.56-0.99）；主动脉僵硬度的测量结果相似（r=0.66-0.99）。然而，对于 CVD 事件，所有颈动脉僵硬度计算的风险比（HR）与标准差变化的比值相似，范围为 1.00-1.10（等效性 P<0.001）。对于主动脉，与主动脉 Peterson 弹性模量（HR 0.98[0.89-1.07]）和主动脉脉搏波速度（HR 1.00[0.90-1.11]）相比，主动脉扩张系数与 CVD 事件的相关性更强（HR 1.18[1.02-1.37]）。所有其他主动脉僵硬度计算的 HR 均等效（P<0.01）。
计算局部动脉僵硬度的不同方法基本给出了等效的结果，这表明目前使用的多种不同的动脉僵硬度计算方法不会导致不一致的发现。
