Department of Ultrasound, Affiliated Hospital of Nanjing University of Chinese Medicine, Jiangsu Province Hospital of Chinese Medicine, Nanjing, China.
Department of Radiology, Affiliated Hospital of Nanjing University of Chinese Medicine, Jiangsu Province Hospital of Chinese Medicine, Nanjing, China.
Acad Radiol. 2024 Oct;31(10):3944-3955. doi: 10.1016/j.acra.2024.05.011. Epub 2024 May 29.
BACKGROUND: To investigate the association between cardiovascular risk estimated using the Framingham Risk Score (FRS) and carotid stiffening determined using ultrafast pulse wave velocity (ufPWV) measurements in apparently healthy individuals. METHODS: We enrolled 1034 apparently healthy participants without known cardiovascular disease who underwent ufPWV measurements. Clinical and laboratory findings, carotid intima-media thickness (cIMT), pulse wave velocity at the beginning of systole (PWV-BS), and pulse wave velocity at the end of systole (PWV-ES) were assessed. In FRS assessments based on major cardiovascular risk factors (CVRFs), participants were assigned into three risk categories: low risk (<10%, n = 679), intermediate risk (10-20%, n = 191), and high risk (>20%, n = 164); the low-risk category was further subdivided into three subcategories: < 1% (n = 58), 1%- 5% (n = 374) and > 5% (n = 247). Multivariate logistic regression analyses with crude and adjusted odds ratios (ORs) were used to evaluate the association of carotid stiffening and FRS-based risk stratification. RESULTS: Carotid stiffening indicated by PWV-BS and PWV-ES differed notably between the FRS-estimated low-risk vs. intermediate-risk and high-risk categories, but only PWV-ES differed notably among the low-risk subcategories (all p < 0.010), and correlated notably with the FRS-estimated risk most obviously in low-risk participants (r = 0.517). In participants with cIMT < 0.050 cm, only PWV-ES differed significantly among the FRS-estimated risk categories (all p < 0.001). Increased PWV-BS (adjusted OR: 1.49; p = 0.003) and PWV-ES (adjusted OR: 1.29; p = 0.007) were both associated with FRS categories independent of conventional CVRFs in low- vs. intermediate-risk categories, but not in low- vs. high-risk categories (all p > 0.050). CONCLUSION: In vivo imaging of carotid stiffening by ufPWV measurements is independently linked to FRS categories, and ufPWV indices may help stratify differing levels of cardiovascular risk in apparently healthy young people. AVAILABILITY OF DATA AND MATERIAL: Data generated or analyzed during the study are available from the corresponding author by reasonable request.
背景：本研究旨在探讨使用弗雷明汉风险评分（Framingham Risk Score，FRS）评估心血管风险与使用超快速脉搏波速度（ultrafast pulse wave velocity，ufPWV）测量颈动脉僵硬度之间的关联，研究对象为看似健康的个体。
方法：我们纳入了 1034 名无已知心血管疾病的看似健康的参与者，他们接受了 ufPWV 测量。评估了临床和实验室检查结果、颈动脉内膜中层厚度（carotid intima-media thickness，cIMT）、收缩期起始脉搏波速度（pulse wave velocity at the beginning of systole，PWV-BS）和收缩期末脉搏波速度（pulse wave velocity at the end of systole，PWV-ES）。根据主要心血管危险因素（cardiovascular risk factors，CVRFs）进行 FRS 评估后，参与者被分为三个风险类别：低风险（<10%，n=679）、中风险（10-20%，n=191）和高风险（>20%，n=164）；低风险类别进一步细分为三个亚组：<1%（n=58）、1%-5%（n=374）和>5%（n=247）。使用未经调整和调整后的比值比（odds ratio，OR）的多变量逻辑回归分析评估颈动脉僵硬度与 FRS 风险分层之间的关联。
结果：PWV-BS 和 PWV-ES 所示的颈动脉僵硬度在 FRS 估计的低风险与中风险和高风险类别之间差异显著，但仅 PWV-ES 在低风险亚组之间差异显著（均 p<0.010），并且与低风险参与者的 FRS 估计风险相关性最强（r=0.517）。在 cIMT<0.050 cm 的参与者中，仅在 FRS 估计的风险类别之间 PWV-ES 差异显著（均 p<0.001）。在低风险与中风险类别中，与常规 CVRFs 相比，PWV-BS（调整后的 OR：1.49；p=0.003）和 PWV-ES（调整后的 OR：1.29；p=0.007）均与 FRS 类别独立相关，但在低风险与高风险类别中不相关（均 p>0.050）。
结论：使用 ufPWV 测量的颈动脉僵硬度的体内成像与 FRS 类别独立相关，ufPWV 指数可能有助于对年轻健康人群的不同心血管风险水平进行分层。
数据和材料的可获取性：通过合理请求，可从相应作者处获取研究期间生成或分析的数据。
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