Role of arterial stiffness in cardiovascular disease.
Role of arterial stiffness in cardiovascular disease.
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DOI：
10.1258/cvd.2012.012016
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发表时间：
2012-07-31
影响因子：
1.6
通讯作者：
Chowienczyk P
中科院分区：
文献类型：
--
作者：
Cecelja M;Chowienczyk P
压力波沿动脉树的传播（脉冲波速度[PWV]）与动脉壁的固有弹性有关。硬化动脉的PWV增加，当在主动脉上测量时，是心血管发病率和死亡率的独立预测因子。鉴于PWV的预测能力，确定预防或减少硬化的策略可能对预防心血管事件很重要。一种观点认为，主动脉硬化是动脉粥样硬化的结果。然而，除了年龄和血压外，PWV与动脉粥样硬化的经典危险因素之间几乎没有关联。此外，通过内膜-中膜厚度和非钙化动脉粥样硬化测量，PWV在动脉粥样硬化的早期阶段不会增加，但在晚期动脉粥样硬化斑块中出现主动脉钙化时，PWV确实会增加。与年龄相关的脉压增宽是高血压患病率与年龄相关增加的主要原因，并归因于动脉硬化。本文综述了测量人类主动脉硬度的方法，导致主动脉硬度的病理生理机制，包括其与动脉粥样硬化的关系，以及主动脉硬度增加对血流动力学的影响。
Propagation of the pressure wave along the arterial tree (pulse wave velocity [PWV]) is related to the intrinsic elasticity of the arterial wall. PWV is increased in stiffer arteries and, when measured over the aorta, is an independent predictor of cardiovascular morbidity and mortality. Given the predictive power of PWV, identifying strategies that prevent or reduce stiffening may be important in prevention of cardiovascular events. One view is that aortic stiffness occurs as a result of atherosclerosis along the aorta. However, there is little or no association between PWV and classical risk factors for atherosclerosis, other than age and blood pressure. Furthermore, PWV does not increase during early stages of atherosclerosis, as measured by intima-media thickness and non-calcified atheroma, but it does increase in the presence of aortic calcification that occurs within advanced atherosclerotic plaque. Age-related widening of pulse pressure is the major cause of age-related increase in prevalence of hypertension and has been attributed to arterial stiffening. This review summarizes the methods of measuring aortic stiffness in humans, the pathophysiological mechanisms leading to aortic stiffness, including its association with atherosclerosis, and the haemodynamic consequences of increased aortic stiffness.