Elevated augmentation index derived from peripheral arterial tonometry is associated with abnormal ventricular-vascular coupling
Elevated augmentation index derived from peripheral arterial tonometry is associated with abnormal ventricular-vascular coupling
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DOI：
10.1111/j.1475-097x.2010.00943.x
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发表时间：
2010-09-01
影响因子：
1.8
通讯作者：
Kuvin, Jeffrey T.
中科院分区：
文献类型：
--
作者：
Heffernan, Kevin S.;Patvardhan, Eshan A.;Kuvin, Jeffrey T.
背景：虽然增强指数（AIx）通常是从动脉压波形的轮廓推导出来的，但也可以使用手指体积描记法（外周动脉张力测定法，PAT）从数字脉搏容积波形推导出来。关于源自PAT的AIx的生理相关性知之甚少。在这项研究中，我们调查的PAT-AIx的心室-血管couption.Methods措施的关系：通过PAT测量脉搏容积波，并用于推导AIx。采用二维超声心动图，有效动脉弹性指数（Effective Arterial Elastance Index，EEP）以收缩末期压/每搏输出量指数（end-systolic pressure/stroke volume index）表示。左心室（LV）收缩末期弹性指数（ELVI）计算为收缩末期压力/收缩末期容积指数。结果：根据超声心动图测量的心室-血管解偶联的双向性，将患者分为3组：低EVR/ELVI（< 0中心点6，n = 21）、最佳EVR/ELVI（平均0中心点6-1中心点2，n = 16）和高EVR/ELVI（> 1中心点2，n = 10）。调整潜在混杂因素（年龄、平均动脉压、身高和心率），最佳EVR/ELVI患者的AIx较低（1 +/-4%，P < 0，中心点05），与低Ehrs/ELVI患者相比（13 +/- 4%）和高ECO 2/ELVI（19 +/- 5%）.结论：由有效动脉弹性增加或心室弹性增加引起的心室-血管偶联异常，与PAT测量的AIx增加相关。还需要进一步的研究来检查PAT-AIx的其他血管相关性。
P>Background:Although typically derived from the contour of arterial pressure waveform, augmentation index (AIx) may also be derived from the digital pulse volume waveform using finger plethysmography (peripheral arterial tonometry, PAT). Little is known regarding the physiologic correlates of AIx derived from PAT. In this study, we investigated the relation of PAT-AIx with measures of ventricular-vascular coupling.Methods:Pulse volume waves were measured via PAT and used to derive AIx. Using 2-dimensional echocardiography, effective arterial elastance index (EaI) was estimated as end-systolic pressure/stroke volume index. Left ventricular (LV) end-systolic elastance index (ELVI) was calculated as end-systolic pressure/end-systolic volume index. Ventricular-vascular coupling ratio was defined as EaI/ELVI.Results:Given the bi-directional nature of ventricular-vascular uncoupling as measured by echocardiography, patients were separated into three groups: low EaI/ELVI (< 0 center dot 6, n = 21), optimal EaI/ELVI (mean 0 center dot 6-1 center dot 2, n = 16) and high EaI/ELVI (> 1 center dot 2, n = 10). Adjusting for potential confounders (age, mean arterial pressure, height and heart rate), patients with optimal EaI/ELVI had lower AIx (1 +/- 4%, P < 0 center dot 05) compared to those with low EaI/ELVI (13 +/- 4%) and high EaI/ELVI (19 +/- 5%).Conclusions:Abnormal ventricular-vascular coupling, arising from either increased effective arterial elastance or increased ventricular elastance, is associated with increased AIx as measured by PAT. Additional research is needed to examine other vascular correlates of PAT-AIx.