Enhanced radial late systolic pressure augmentation in hypertensive patients with left ventricular hypertrophy
Enhanced radial late systolic pressure augmentation in hypertensive patients with left ventricular hypertrophy
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DOI：
10.1016/j.amjhyper.2005.06.017
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发表时间：
2006-01-01
影响因子：
3.2
通讯作者：
Imai, Y
中科院分区：
文献类型：
--
作者：
Hashimoto, J;Watabe, D;Imai, Y
背景：波反射增加收缩期后期的中心血压，从而增加心脏后负荷。我们研究了高血压患者桡动脉外周脉搏波收缩压晚期升高与左心室肥厚（LVH）的关系。方法：测定77例56 ~ 10岁未经治疗的高血压患者肱BP、桡动脉增强指数（AIr）和颈股脉波速度（PWVcf）。超声评估心脏结构和功能，根据左室质量指数（LVMI）确定LVH。通过多变量分析，比较LVH（+）和LVH（-）患者的特征。结果：LVMI与Al-r （beta = 0.33, P = 0.004）、肱平均动脉压（MAP; beta = 0.25, P = 0.03）独立正相关。舒张期传导血流的早期与心房峰值流速之比（E/A）与Al-r呈负相关。LVH（+）组Al-r显著高于LVH（-）组[LVH（+）组97% vs LVH（-）组89%，P = 0.003]；即使在调整了年龄、性别、MAP和心率后，这种差异仍然显著。Al-r每增加10%，LVH的校正相对危险度为1.99 （P = 0.005）。LVMI与PWVcf无相关性，LVH（+）组与LVH（-）组PWVcf无差异。PWVcf与Al-r无显著相关。结论：这些结果表明外周Al-r测量在临床上预测LVH是有用的。波反射增强可能与高血压患者LVH的发展有关。
Background: Wave reflection augments central blood pressure (BP) in late systole, thus increasing cardiac afterload. We examined the relationship between late systolic pressure augmentation in the peripheral radial artery pulse wave and the existence of left ventricular hypertrophy (LVH) in hypertension.Methods: Brachial BP, radial augmentation index (AIr), and carotid-femoral pulse wave velocity (PWVcf) were determined in 77 untreated hypertensive patients aged 56 10 years. Cardiac structure and function were assessed by ultrasound, and LVH was defined based on the LV mass index (LVMI). Using multivariate analysis, patient characteristics were compared between those with (+) and without (-) LVH.Results: The LVMI was correlated independently and positively with Al-r (beta = 0.33, P = .004) and the brachial mean arterial pressure (MAP; beta = 0.25, P = .03). The ratio of early to atrial peak velocities (E/A ratio) of the diastolic transmittal flow tended to be correlated negatively with the Al-r. The LVH (+) group had a significantly 0, higher Al-r than the LVH (-) group [LVH (+), 97% v LVH (-), 89%, P = .003]; this difference remained significant even after adjustment for age, gender, MAP, and heart rate. The adjusted relative risk of LVH was 1.99 for each 10% Al-r increase (P = .005). In contrast, LVMI was not correlated with the PWVcf, and the PWVcf was not different between the LVH (+) and LVH (-) groups. Moreover, there was no significant correlation between PWVcf and Al-r.Conclusions: These results suggest that the peripheral Al-r measurement is clinically useful in predicting LVH. Enhanced wave reflection may be related to the development of LVH in hypertensive patients.