Department of Clinical Sciences, Lund University, Malmö, Sweden; Department of Cardiology, Skåne University Hospital, Malmö, Sweden.
Department of Clinical Sciences, Lund University, Malmö, Sweden; Department of Cardiology, Skåne University Hospital, Malmö, Sweden; Wallenberg Center for Molecular Medicine, Lund University, Lund, Sweden; Hypertension in Africa Research Team (HART), North-West University, Potchefstroom, South Africa.
Atherosclerosis. 2023 Jun;374:11-20. doi: 10.1016/j.atherosclerosis.2023.04.010. Epub 2023 Apr 22.
Data exploring normal values of different ventricular-arterial coupling (VAC) parameters and their association with anthropometric and cardiovascular (CV) factors are scarce. We aim to report values of two different methods of VAC assessment according to age and sex and explore their association with CV factors within a large population-based cohort of middle-aged individuals.
For 1333 (mean age 48 ± 14) individuals participating in the 4th visit of the STANISLAS cohort, VAC was assessed by two methods [1]: arterial elastance (E)/end-systolic elastance (E) and [2] Pulse wave velocity (PWV)/Global longitudinal strain (GLS).
The mean values of E/E and PWV/GLS were 1.06 ± 0.20 and 0.42 ± 0.12, respectively. The two methods of VAC assessment were poorly correlated (Pearson's correlation coefficient r = 0.14 (0.08; 0.19)). Increased PWV/GLS was associated with older age and a higher degree of cardiovascular risk factors (i.e., BMI, blood pressure, LDL, diabetes, hypertension) in the whole population as well as in the parent generation. In contrast, higher E/E were associated with decreasing age, and lower prevalence of risk factors in the whole cohort but neutrally associated with risk factors in the parent generation.
Higher PWV/GLS is significantly associated with CV factors regardless of age. In contrast, worse E/E is associated with a better CV risk profile when considering individuals aged 30 to 70 but neutrally associated with CV factors when considering only older patients. These results may suggest that PWV/GLS should preferably be used to explore VAC. In addition, age-individualized threshold of E/E should be used.
探索不同心室-动脉偶联(VAC)参数的正常值及其与人体测量学和心血管(CV)因素的关系的数据很少。我们旨在报告根据年龄和性别评估两种不同 VAC 评估方法的值,并在一个中年人群的大型基于人群的队列中探索它们与 CV 因素的关系。
对于参加 STANISLAS 队列第 4 次访问的 1333 名(平均年龄 48 ± 14)个体,通过两种方法评估 VAC:动脉僵硬度(E)/收缩末期僵硬度(E)和[2]脉搏波速度(PWV)/整体纵向应变(GLS)。
E/E 和 PWV/GLS 的平均值分别为 1.06 ± 0.20 和 0.42 ± 0.12。两种 VAC 评估方法相关性较差(Pearson 相关系数 r = 0.14(0.08;0.19))。在整个人群以及亲代中,较高的 PWV/GLS 与年龄较大和更高程度的心血管危险因素(即 BMI、血压、LDL、糖尿病、高血压)相关。相比之下,较高的 E/E 与年龄减小和整个队列中危险因素的发生率降低相关,但在亲代中与危险因素中性相关。
无论年龄大小,较高的 PWV/GLS 与 CV 因素显著相关。相反,当考虑 30 至 70 岁的个体时,E/E 较差与 CV 风险状况较好相关,但仅考虑较年长的患者时,E/E 与 CV 因素中性相关。这些结果可能表明,应优选使用 PWV/GLS 来探索 VAC。此外,应使用个体化年龄的 E/E 阈值。