Fu Tingting, Pan Yu, Sun Qiaobing, Zhang Xiujie, Cong Tao, Jiang Yinong, Liu Yan
Department of Cardiology, First Affiliated Hospital of Dalian Medical University, Dalian, Liaoning, China.
Hypertens Res. 2023 Oct;46(10):2378-2387. doi: 10.1038/s41440-023-01390-z. Epub 2023 Aug 2.
Hypertension induces left atrial (LA) and left ventricular (LV) dysfunction, and an increase in arterial stiffness. This study aimed to investigate the associations of brachial-ankle pulse wave velocity (baPWV) with LA stiffness and LA phasic function in hypertension. A total of 305 hypertensive inpatients enrolled and were divided into two groups based on baPWV [Group I, baPWV ≤ 1515 (cm/s), n = 153; Group II, baPWV > 1515 (cm/s), n = 152]. Two-dimensional speckle tracking echocardiography (2D-STE) based LA phasic strains (LA, LA, LA) and LV global longitudinal strain (LVGLS) were evaluated. LA stiffness index (LASI) was defined as the ratio of E/e' to LA. Multivariate linear regression modeling was used to analyze the associations of baPWV with LASI and LA phasic function in all patients as well as age-specific and sex-specific subgroups. LASI was significantly higher in Group II [0.35(0.26, 0.52)] compared with Group I [0.26(0.20, 0.36)] (P < 0.001). After adjusting cardiovascular risk factors, medication, and LV structural and functional parameters (LVEF, LVMI, E/A ratio, and LVGLS), baPWV remained significantly correlated with LASI (P < 0.05). We also evaluated the predictive value of baPWV for LASI, the area under the curve (AUC) was 0.663 (95% CI: 0.607-0.716, P < 0.001). In conclusion, BaPWV was independently associated with LA stiffness in hypertensive inpatients. BaPWV also exhibited a certain predictive value for LA stiffness in these inpatients. Measuring arterial stiffness can provide clinicians clues for early cardiac target organ damage (TOD) in addition to vascular TOD.
高血压会导致左心房(LA)和左心室(LV)功能障碍以及动脉僵硬度增加。本研究旨在探讨高血压患者肱踝脉搏波速度(baPWV)与LA僵硬度及LA相位功能之间的关联。共纳入305例高血压住院患者,并根据baPWV分为两组[第一组,baPWV≤1515(cm/s),n = 153;第二组,baPWV>1515(cm/s),n = 152]。采用二维斑点追踪超声心动图(2D-STE)评估LA相位应变(LA、LA、LA)和LV整体纵向应变(LVGLS)。LA僵硬度指数(LASI)定义为E/e'与LA的比值。采用多变量线性回归模型分析所有患者以及按年龄和性别分层的亚组中baPWV与LASI及LA相位功能的关联。与第一组[0.26(0.20,0.36)]相比,第二组[0.35(0.26,0.52)]的LASI显著更高(P<0.001)。在调整心血管危险因素、药物治疗以及LV结构和功能参数(LVEF、LVMI、E/A比值和LVGLS)后,baPWV仍与LASI显著相关(P<0.05)。我们还评估了baPWV对LASI的预测价值,曲线下面积(AUC)为0.663(95%CI:0.607 - 0.716,P<0.001)。总之,baPWV与高血压住院患者的LA僵硬度独立相关。baPWV对这些住院患者的LA僵硬度也具有一定的预测价值。测量动脉僵硬度除了能为血管靶器官损害提供线索外,还可为临床医生提供早期心脏靶器官损害(TOD)的线索。