Increased ambulatory pulse pressure is a strong risk factor for coronary endothelial vasomotor dysfunction
Increased ambulatory pulse pressure is a strong risk factor for coronary endothelial vasomotor dysfunction
复制标题
DOI：
10.1016/j.jacc.2005.01.038
复制
发表时间：
2005-05-03
影响因子：
24
通讯作者：
Kugiyama, K
中科院分区：
文献类型：
--
作者：
Ichigi, Y;Takano, H;Kugiyama, K
本研究旨在确定脉压（PP）与冠状动脉血管功能障碍（冠状动脉事件的预测因子）之间的关系。脉压是冠状动脉疾病（CAD）的一个重要危险因素。然而，PP增加影响CAD发病机制的机制尚不清楚。对103例冠状动脉造影正常的连续患者（51例高血压和52例血压正常;年龄42 ~ 70岁）进行24小时动态血压（13 P）监测。冠状动脉内灌注乙酰胆碱（ACh）（5，10，50 μ g/min）期间冠状动脉直径和血流变化与BP参数和其他传统危险因素之间的关系采用单变量和多变量线性回归分析进行评价。多变量分析显示，24小时PP与心外膜冠状动脉扩张剂对ACh的反应呈负相关，与其他协变量无关，包括年龄、吸烟和血压正常和高血压患者的24小时收缩压。此外，多因素分析显示，24小时PP与ACh引起的冠状动脉血流量增加呈负相关。心外膜冠状动脉对硝酸盐的扩张反应与24小时PP无显著相关性。无论是否存在高血压，24小时PP增加与导管和阻力冠状动脉内皮血管功能障碍独立相关。动态PP增高可能与冠状动脉内皮功能障碍密切相关。(c)2005年，美国心脏病学会基金会。
This study was aimed to determine the relationship between pulse pressure (PP) and coronary vasomotor dysfunction, a predictor of coronary events. Pulse pressure is a strong risk factor for coronary artery disease (CAD). However, the mechanisms by which an increase in PP affiects the pathogenesis of CAD are unclear. Ambulatory blood pressure (13P) monitoring for 24 h was performed in 103 consecutive patients with normal coronary angiograms (51 hypertensive and 52 normotensive; age 42 to 70 years). The relationship between changes in coronary arterial diameter and blood flow during an intracoronary infusion of acetylcholine (ACh) (5, 10, 50 mu g/min), and BP parameters, and other traditional risk factors was evaluated using univariate and multivariate linear regression analyses. With multivariate analyses, the 24-h PP showed an inverse correlation with the epicardial coronary dilator response to ACh independently of other covariates including age, smoking, and 24-h systolic BP in normotensive as well as hypertensive patients. Furthermore, multivariate analysis showed that the 24-h PP was inversely and independently correlated with the increase in coronary blood flow in response to ACh. The dilator response of epicardial coronary arteries to nitrate was not significantly correlated with 24-h PP. Increased 24-h PP is independently associated with endothelial vasomotor dysfunction in conduit and resistance coronary arteries irrespective of the presence of hypertension. Increased ambulatory PP may have an intimate relation to coronary endothelial vasomotor dysfiinction. (c) 2005 by the American College of Cardiology Foundation.