Arterial Stiffness and Pulse Wave Reflection in Young Adult Heterozygous Sickle Cell Carriers
Arterial Stiffness and Pulse Wave Reflection in Young Adult Heterozygous Sickle Cell Carriers
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DOI：
10.4274/tjh.2012.0205
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发表时间：
2013-12-01
影响因子：
2.6
通讯作者：
Acarturk, Esmeray
中科院分区：
文献类型：
--
作者：
Bayramoglu, Tunzale;Akkus, Oguz;Acarturk, Esmeray
目的：脉搏波传导速度（PWV）和主动脉增强指数（AI）是反映动脉僵硬度的指标。脉搏波反射和动脉僵硬度与心血管事件和镰状细胞病有关。然而，这些参数对杂合子镰状细胞性状（HbAS）的影响是未知的。本研究的目的是评估动脉僵硬度和波反射在年轻成人杂合子镰状细胞carriers.Materials和方法：我们招募了40名志愿者（20 HbAS病例，20血红蛋白AA [HbAA]病例），年龄在18至40岁之间。结果：HbAS组主动脉血压、主动脉AI和肱动脉AT值均显著高于对照组（HbAA）（p分别为0.033、0.011和0.011）。在整个研究人群中，发现主动脉脉搏波速度与平均动脉压、年龄、主动脉AI、肱动脉AI、体重和低密度脂蛋白水平之间存在统计学显著正相关（分别为p=0.000、0.017、0.000、0.000、0.034和0.05）。主动脉AT和年龄也显著相关（p=0.026）。此外，在HbAS个体中发现主动脉PWV与收缩压之间呈正相关，主动脉AT与平均动脉压之间呈正相关（分别为p=0.027和0.009）。我们的研究表明，平均动脉压和心率是主动脉AI的独立决定因素。平均动脉压和年龄是主动脉PWV的独立决定因素。结论：动脉僵硬度测量是一种简单，廉价，可靠的方法，在早期诊断心血管疾病的杂合子镰状细胞携带者。这些结果可能取决于红细胞中血红蛋白S的量。进一步的研究需要调查血压变化及其对动脉硬度的影响，以解释HbAS特质人群的血管老化机制。
Objective: Pulse wave velocity (PWV) and aortic augmentation index (AI) are indicators of arterial stiffness. Pulse wave reflection and arterial stiffness are related to cardiovascular events and sickle cell disease. However, the effect of these parameters on the heterozygous sickle cell trait (HbAS) is unknown. The aim of this study is to evaluate the arterial stiffness and wave reflection in young adult heterozygous sickle cell carriers.Materials and Methods: We enrolled 40 volunteers (20 HbAS cases, 20 hemoglobin AA [HbAA] cases) aged between 18 and 40 years. AI and PWV values were measured by arteriography.Results: Aortic blood pressure, aortic AI, and brachial AT values were significantly higher in HbAS cases compared to the control group (HbAA) (p=0.033, 0.011, and 0.011, respectively). A statistically significant positive correlation was found between aortic pulse wave velocity and mean arterial pressure, age, aortic AI, brachial AI, weight, and low-density lipoprotein levels (p=0.000, 0.017, 0.000, 0.000, 0.034, and 0.05, respectively) in the whole study population. Aortic AT and age were also significantly correlated (p=0.026). In addition, a positive correlation between aortic PWV and systolic blood pressure and a positive correlation between aortic AT and mean arterial pressure (p=0.027 and 0.009, respectively) were found in HbAS individuals. Our study reveals that mean arterial pressure and heart rate are independent determinants for the aortic AI. Mean arterial pressure and age are independent determinants for aortic PWV.Conclusion: Arterial stiffness measurement is an easy, cheap, and reliable method in the early diagnosis of cardiovascular disease in heterozygous sickle cell carriers. These results may depend on the amount of hemoglobin S in red blood cells. Further studies are required to investigate the blood pressure changes and its effects on arterial stiffness in order to explain the vascular aging mechanism in the HbAS trait population.