Gender differences in the timing of arterial wave reflection beyond differences in body height
Gender differences in the timing of arterial wave reflection beyond differences in body height
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DOI：
10.1097/00004872-200112000-00013
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发表时间：
2001-12-01
影响因子：
4.9
通讯作者：
Dart, AM
中科院分区：
文献类型：
--
作者：
Gatzka, CD;Kingwell, BA;Dart, AM
目的动脉波反射的时间影响动脉波形的形状，因此是脉压的主要决定因素。这项研究评估了性别之间的波反射差异，而不是身高的影响。方法从1123例（71 +/- 5岁）未接受治疗的老年高血压患者中选取104对身高相同（平均164 +/- 4 cm）的男女。所有受试者都接受了超声心动图检查，包括测量主动脉弓扩张、自动血压测量、测量升主动脉血流量和同时测量颈动脉张力。结果女性脉搏增高（80 +/- 17比74 +/- 17 mmHg， P < 0.05），舒张压降低（79 +/- 11比82 +/- 10 mmHg， P < 0.05）。虽然心率相似，但女性达到收缩压峰值的时间更长（210 +/- 28 ms对199 +/- 34 ms， P < 0.01），射血时间更长（304 +/- 21 ms对299 +/- 25 ms， P < 0.001）。波反射在女性中发生得更早（最大值116 +/- 55 ms vs 132 +/- 47 ms， P < 0.05），增强指数更高（36 +/- 11 ms vs 28 +/- 12%, P < 0.001）。女性的主动脉直径更小，主动脉弓更硬（中位E-p 386 vs 302 kN/m， P < 0.05）。因此，女性全身动脉顺应性较低（0.8 +/- 0.2 vs 1.0 +/- 0.3 ml/mmHg）。结论老年高血压男性和女性在身高匹配的情况下，左心室射血时间和动脉波反射时间不同。女性的血管更小、更硬，反射波返回时间更早，这可能是由于女性的脉搏波速度增加所致。[J]中华医学杂志，2001,19(3):391 - 391。
Objectives The timing of arterial wave reflection affects the shape of the arterial waveform and thus is a major determinant of pulse pressure. This study assessed differences in wave reflection between genders beyond the effect of body height.Methods From 1123 elderly (aged 71 +/- 5 years) currently untreated hypertensives, we selected 104 pairs of men and women with identical body height (average 164 +/- 4 cm). All subjects underwent echocardiography, including measurement of aortic arch expansion, automated blood pressure measurements, measurement of ascending aortic blood flow and simultaneous carotid artery tonometry.Results Women had higher pulse (80 +/- 17 versus 74 +/- 17 mmHg, P < 0.05) and lower diastolic pressure (79 +/- 11 versus 82 +/- 10 mmHg, P < 0.05). Whilst heart rate was similar, women had a longer time to the systolic peak (210 +/- 28 versus 199 +/- 34 ms, P < 0.01) and a longer ejection time (304 +/- 21 versus 299 +/- 25 ms, P < 0.001). Wave reflection occurred earlier in women (time between maxima 116 +/- 55 versus 132 +/- 47 ms, P < 0.05) and augmentation index was higher (36 +/- 11 versus 28 +/- 12%, P < 0.001). Aortic diameter was smaller in women and the aortic arch was stiffer (median E-p 386 versus 302 kN/m(2), P < 0.05). Hence, systemic arterial compliance was less in women (0.8 +/- 0.2 versus 1.0 +/- 0.3 ml/mmHg).Conclusions We conclude that elderly hypertensive men and women have a different timing of both left ventricular ejection and arterial wave reflection when both genders are matched for body height Women have smaller and stiffer blood vessels resulting in an earlier return of the reflected wave, which is likely due to an increased pulse wave velocity in women. J Hypertens 19:2197-2203 (C) 2001 Lippincott Williams & Wilkins.