Usefulness of Brachial Artery Flow-Mediated Dilation to Predict Long-Term Cardiovascular Events in Subjects Without Heart Disease
Usefulness of Brachial Artery Flow-Mediated Dilation to Predict Long-Term Cardiovascular Events in Subjects Without Heart Disease
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DOI：
10.1016/j.amjcard.2013.08.051
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发表时间：
2014-01-01
影响因子：
2.8
通讯作者：
Hiersch, Liran
中科院分区：
文献类型：
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作者：
Shechter, Michael;Shechter, Alon;Hiersch, Liran
内皮功能障碍被认为是动脉粥样硬化的重要预后因素。为了确定健康受试者肱动脉血流介导扩张（FM）与不良心血管事件的长期关系，我们前瞻性地评估了618名连续无明显心脏病的健康受试者、387名男性（63%）、平均年龄54 - 11岁的肱动脉血流介导扩张（FM）。禁食过夜并停用所有药物数小时后，使用高分辨率线性阵列超声评估FMD。受试者被分为两组：FMD 11.3% (n = 309)，其中11.3%为中位FMD，在CV危险因素、脂蛋白、空腹血糖、c反应蛋白、伴随药物和Framingham 10年风险评分方面具有可比性。在平均4.6 +/- 1.8年的临床随访中，复合CV事件（全因死亡率、非致死性心肌梗死、因心力衰竭或心绞痛住院、中风、冠状动脉旁路移植术和经皮冠状动脉介入治疗）在FMD患者中更为常见（分别为15.2%和1.2%,p = 0.0001）。单因素分析表明，中位FMD显著预测CV事件（优势比2.78,95% CI 1.35 ~ 5.71, p . 571）
Endothelial dysfunction is considered an important prognostic factor in atherosclerosis. To determine the long-term association of brachial artery flow-mediated dilation (FM])) and adverse cardiovascular (CV) events in healthy subjects, we prospectively assessed brachial FMD in 618 consecutive healthy subjects with no apparent heart disease, 387 men (63%), and mean age 54 11 years. After overnight fasting and discontinuation of all medications for hours, FMD was assessed using high-resolution linear array ultrasound. Subjects were divided into 2 groups: FMD 11.3% (n = 309), where 11.3% is the median FMD, and were comparable regarding CV risk factors, lipoproteins, fasting glucose, C-reactive protein, concomitant medications, and Framingham 10-year risk score. In a mean clinical follow-up of 4.6 +/- 1.8 years, the composite CV events (all-cause mortality, nonfatal myocardial infarction, hospitalization for heart failure or angina pectoris, stroke, coronary artery bypass grafting, and percutaneous coronary interventions) were significantly more common in subjects with FMD 11.3% (15.2% vs 1.2%, p = 0.0001, respectively). Univariate analysis demonstrated that the median FMD significantly predicted CV events (odds ratio 2.78, 95% CI 1.35 to 5.71, p