估计脉搏波速度与新发心力衰竭及其亚型：动脉粥样硬化多民族研究的结果
Estimated pulse wave velocity and incident heart failure and its subtypes: Findings from the multi-ethnic study of atherosclerosis.
作者信息
Heffernan Kevin S, Charry Daniela, Xu Jing, Tanaka Hirofumi, Churilla James R
机构信息
Department of Exercise Science, Syracuse University, 820 Comstock Ave, The Women's Building Suite 100, Syracuse, NY 13244, USA.
Department of Kinesiology and Health Education, The University of Texas at Austin, 2109 San Jacinto Blvd, Austin, TX 78712, USA.
出版信息
Am Heart J Plus. 2023 Jan;25. doi: 10.1016/j.ahjo.2022.100238. Epub 2022 Dec 5.
UNLABELLED
Age-associated increase in aortic stiffness, measured as carotid-femoral pulse wave velocity (PWV), is an important effector of cardiac damage and heart failure (HF). Pulse wave velocity estimated from age and blood pressure (ePWV) is emerging as a useful proxy of vascular aging and subsequent cardiovascular disease risk. We examined the association of ePWV with incident HF and its subtypes in a large community sample of 6814 middle-aged and older adults from the Multi-Ethnic Study of Atherosclerosis (MESA).
METHODS
Participants with an ejection fraction ≤40 % were classified as HF with reduced ejection fraction (HFrEF) while those with an ejection fraction ≥50 % were classified as HF with preserved ejection fraction (HFpEF). Cox proportional hazards regression models were used to calculate hazard ratios (HR) and 95 % confidence intervals (CI).
RESULTS
Over a mean follow-up period of 12.5 years, incident HF was diagnosed in 339 participants: 165 were classified as HFrEF and 138 as HFpEF. In fully adjusted models, the highest quartile of ePWV was significantly associated with an increased risk of overall HF (HR 4.79, 95 % CI 2.43-9.45) compared with the lowest quartile (reference). When exploring HF subtypes, the highest quartile of ePWV was associated with HFrEF (HR 8.37, 95 % CI 4.24-16.52) and HFpEF (HR 3.94, 95 % CI 1.39-11.17).
CONCLUSIONS
Higher ePWV values were associated with higher rates of incident HF and its subtypes in a large, diverse cohort of men and women.
未标注
以颈股脉搏波速度（PWV）衡量的与年龄相关的主动脉僵硬度增加是心脏损伤和心力衰竭（HF）的重要影响因素。根据年龄和血压估算的脉搏波速度（ePWV）正成为血管衰老及后续心血管疾病风险的有用替代指标。我们在动脉粥样硬化多民族研究（MESA）中对6814名中老年成年人的大型社区样本进行了研究，以探讨ePWV与新发HF及其亚型之间的关联。
方法
射血分数≤40%的参与者被归类为射血分数降低的HF（HFrEF），而射血分数≥50%的参与者被归类为射血分数保留的HF（HFpEF）。采用Cox比例风险回归模型计算风险比（HR）和95%置信区间（CI）。
结果
在平均12.5年的随访期内，339名参与者被诊断为新发HF：165例被归类为HFrEF，138例被归类为HFpEF。在完全调整模型中，与最低四分位数（参照组）相比，ePWV最高四分位数与总体HF风险增加显著相关（HR 4.79，95%CI 2.43 - 9.45）。在探索HF亚型时，ePWV最高四分位数与HFrEF（HR 8.37，95%CI 4.24 - 16.52）和HFpEF（HR 3.94，95%CI 1.39 - 11.17）相关。
结论
在一个由男性和女性组成的大型多样化队列中，较高的ePWV值与较高的新发HF及其亚型发生率相关。
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