Aortic stiffness is associated with atherosclerosis of the coronary arteries in older adults: the Rotterdam Study
Aortic stiffness is associated with atherosclerosis of the coronary arteries in older adults: the Rotterdam Study
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DOI：
10.1097/01.hjh.0000251896.62873.c4
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发表时间：
2006-12-01
影响因子：
4.9
通讯作者：
Witteman, Jacqueline C. M.
中科院分区：
文献类型：
--
作者：
van Popele, Nicole M.;Mattace-Raso, Francesco U. S.;Witteman, Jacqueline C. M.
目的主动脉僵硬可导致舒张压降低，从而可能限制冠状动脉血流灌注。因此，同时发生主动脉僵硬和冠状动脉粥样硬化会增加心内膜下缺血的风险。本研究旨在探讨主动脉僵硬与冠状动脉粥样硬化的关系。方法研究对象为鹿特丹研究的1757名受试者。鹿特丹研究是一项基于人群的老年人研究。通过测量颈动脉-股动脉脉搏波速度(PWV)评估主动脉硬度。通过电子束断层扫描测量冠状动脉钙化程度来评估冠状动脉粥样硬化，并将其表示为总钙化评分。由于钙离子的偏态分布，钙离子的总分呈对数变换。在调整了年龄、性别、平均动脉压和心率后，首先评估PWV与冠状动脉钙化的相关性。结果线性回归分析显示，PWV增加与冠状动脉总钙化的对数相关[β-回归系数0.11，95%可信区间(CI)0.07~0.15]。与PWV的最低四分位数相比，第二、第三和第四最高四分位数发生晚期冠状动脉钙化的多变量优势比和相应的95%可信区间分别为1.17(0.79-1.74)、1.58(1.07-2.34)和2.12(1.40-3.20)。结论在这项以老年人为基础的大型人群研究中，主动脉僵硬与冠状动脉粥样硬化密切相关。
Objective Aortic stiffness can lead to low diastolic blood pressure, thereby possibly limiting coronary perfusion. Therefore, the simultaneous occurrence of both aortic stiffness and coronary atherosclerosis can lead to an increased risk of subendocardial ischaemia. The aim of the present study was to investigate the association between aortic stiffness and coronary atherosclerosis.Methods The study was performed in 1757 subjects of the Rotterdam Study, a population-based study of elderly individuals. Aortic stiffness was assessed by measuring carotid-femoral pulse wave velocity (PWV). Coronary atherosclerosis was assessed by measuring coronary calcification using electron beam tomography and expressed as a total calcium score. The total calcium score was log-transformed because of its skewed distribution. The association between PWV and coronary calcification was first evaluated after adjustment for age, sex, mean arterial blood pressure and heart rate.Results Linear regression analyses showed that increased PWV was associated with a higher log total coronary calcium score [beta-regression coefficient 0.11, 95% confidence interval (CI) 0.07-0.15]. Compared with the lowest quartile of PWV, multivariate odds ratios and corresponding 95% CI for advanced coronary calcification in the second, third and fourth highest quartiles were 1.17 (0.79-1.74), 1.58 (1.07-2.34) and 2.12 (1.40-3.20), respectively.Conclusions In this large population-based study performed in elderly subjects aortic stiffness was strongly and independently associated with coronary atherosclerosis.