Prediction of cardiovascular events and all-cause mortality with central haemodynamics: a systematic review and meta-analysis
Prediction of cardiovascular events and all-cause mortality with central haemodynamics: a systematic review and meta-analysis
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DOI：
10.1093/eurheartj/ehq024
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发表时间：
2010-08-01
影响因子：
39.3
通讯作者：
Stefanadis, Christodoulos
中科院分区：
文献类型：
--
作者：
Vlachopoulos, Charalambos;Aznaouridis, Konstantinos;Stefanadis, Christodoulos
通过纵向研究的荟萃分析，计算中心压和衍生的中心血流动力学指数对心血管（CV）结局和全因死亡率的预测价值的可靠定量估计，我们荟萃分析了11项采用中心血流动力学指标的纵向研究，并随访了5648例受试者，平均随访时间为45个月。总CV事件的年龄和风险因素校正的合并相对风险（RR）为1.088（95% CI 1.040-1.139）中心收缩压升高10 mmHg，1.137中心脉压（PP）增加10 mmHg时，平均舒张压（95% CI 1.063-1.215）;中心增强指数（AIx）绝对增加10%时，平均舒张压（95% CI 1.093-1.588）。此外，我们发现中央AIx增加10%与全因死亡率的RR为1.384（95%CI 1.192-1.606）相关。与肱动脉PP相比，中央PP与临床事件的RR略有相关，但无显著性差异（P = 0.057）。中央血流动力学指标是未来CV事件和全因死亡率的独立预测因子。增强指数独立于外周压力预测临床事件，而中央PP与外周PP相比具有略微但不显著（P = 0.057）更好的预测能力。
To calculate robust quantitative estimates on the predictive value of central pressures and derived central haemodynamic indices for cardiovascular (CV) outcomes and all-cause mortality by meta-analysis of longitudinal studies.We meta-analysed 11 longitudinal studies that had employed measures of central haemodynamics and had followed 5648 subjects for a mean follow-up of 45 months. The age- and risk-factor-adjusted pooled relative risk (RR) of total CV events was 1.088 (95% CI 1.040-1.139) for a 10 mmHg increase of central systolic pressure, 1.137 (95% CI 1.063-1.215) for a 10 mmHg increase of central pulse pressure (PP), and 1.318 (95% CI 1.093-1.588) for a 10% absolute increase of central augmentation index (AIx). Furthermore, we found that a 10% increase of central AIx was associated with a RR of 1.384 (95% CI 1.192-1.606) for all-cause mortality. When compared with brachial PP, central PP was associated with marginally but not significantly higher RR of clinical events (P = 0.057).Central haemodynamic indexes are independent predictors of future CV events and all-cause mortality. Augmentation index predicts clinical events independently of peripheral pressures, while central PP has a marginally but not significantly (P = 0.057) better predictive ability when compared with peripheral PP.