Radial Artery Tonometry is Associated With Major Adverse Cardiac Events in Patients With Peripheral Artery Disease.
Radial Artery Tonometry is Associated With Major Adverse Cardiac Events in Patients With Peripheral Artery Disease.
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桡动脉张力测定与周围动脉疾病患者的主要不良心脏事件相关。
DOI：
10.1016/j.jss.2018.09.088
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发表时间：
2019
期刊：
影响因子：
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通讯作者：
MarleneGrenon,S
中科院分区：
文献类型：
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作者：
Ramirez,JoelL;Spaulding,KimberlyA;Zahner,GregJ;Khetani,SukaynahA;Schaller,MelindaS;Gasper,WarrenJ;Hills,NancyK;MarleneGrenon,S
背景外周动脉疾病（PAD）与动脉硬度增加有关，通过增加桡动脉增强指数（AIX）来衡量。然而，尚未明确证明 AIX 是否与 PAD 人群的不良心血管结局相关。 材料和方法 2011 年至 2016 年间招募了 72 名 PAD 患者。在基线访视时进行桡动脉压平张力测量，并使用脉搏波分析计算标准化为 75 次/分钟的中央 AIX 和外周 AIX。通过随后的图表审查确定了主要不良心脏事件 (MACE)。 结果研究对象患有通常与 PAD 相关的合并症，包括高血压 (93%)、高脂血症 (85%)、冠状动脉疾病 (39%) 和糖尿病 (39%) 的高患病率。在中位随访时间 34 个月（四分位数范围 29-38）内，14 名患者经历了 MACE。在单变量 Cox 比例风险模型中，外周 AIX 增加 10 个单位与 MACE 发生率增加 54% 显着相关（风险比 [HR] 1.54，95% 置信区间 [CI] 1.06-2.22，P= 0.02），但标准化为 75 次/分钟的中枢 AIX 则不然（HR 1.33，95% CI） 0.71-2.47，P=0.37）。在根据冠状动脉疾病、年龄和卢瑟福类别进行调整的多变量模型中，外周 AIX 仍然与 MACE 显着相关（HR 1.70，95% CI 1.10-2.62，P = 0.02）。 结论 通过外周 AIX 测量的动脉硬度增加与 PAD 患者 MACE 发生率增加独立相关。应考虑使用桡动脉张力计作为 PAD 患者风险分层的工具。
BackgroundPeripheral artery disease (PAD) is associated with increased arterial stiffness, as measured by an increasing radial artery augmentation index (AIX). However, it has not yet been clearly demonstrated whether AIX is associated with adverse cardiovascular outcomes in a PAD population.Materials and methodsSeventy-two patients with PAD were recruited between 2011 and 2016. Radial artery applanation tonometry was performed at a baseline visit, and the central AIX, normalized to 75 beats/min, and the peripheral AIX were calculated using pulse wave analysis. Incident major adverse cardiac events (MACEs) were identified by subsequent chart review.ResultsStudy subjects had comorbidities commonly associated with PAD including a high prevalence of hypertension (93%), hyperlipidemia (85%), coronary artery disease (39%), and diabetes mellitus (39%). During a median follow-up period of 34 mo (interquartile range 29-38), 14 patients experienced a MACE. In a univariate Cox proportional hazards model, a 10-unit increase in the peripheral AIX was significantly associated with a 54% increased rate of MACE (hazard ratio [HR] 1.54, 95% confidence interval [CI] 1.06-2.22,P= 0.02), but central AIX, normalized to 75 beats/min, was not (HR 1.33, 95% CI 0.71-2.47,P= 0.37). In a multivariable model adjusted for coronary artery disease, age, and Rutherford category the peripheral AIX remained significantly associated with MACE (HR 1.70, 95% CI 1.10-2.62,P= 0.02).ConclusionsIncreased arterial stiffness, as measured by the peripheral AIX, was independently associated with an increased rate of MACE in patients with PAD. The use of radial artery tonometry should be contemplated as a tool for risk stratification in patients with PAD.