Carotid Artery Stiffness and Development of Hypertension in People with Paraplegia and No Overt Cardiovascular Disease: A 7-year Follow-up Study.
Carotid Artery Stiffness and Development of Hypertension in People with Paraplegia and No Overt Cardiovascular Disease: A 7-year Follow-up Study.
复制标题
DOI：
10.4103/jcecho.jcecho_43_17
复制
发表时间：
2017-10
影响因子：
0.8
通讯作者：
Antonini-Canterin F
中科院分区：
文献类型：
--
作者：
Vriz O;Bertin N;Ius A;Bizzarini E;Bossone E;Antonini-Canterin F
本研究的目的是比较截瘫患者和健全人 (ABP) 之间的动脉僵硬度，并评估可能预测脊髓损伤 (SCI) 患者动脉高血压发展的心血管标志物。这项研究是在乌迪内（意大利）康复医院进行的。前瞻性纳入 57 名 SCI 患者，并与 88 名健康 ABP 进行比较。所有患者均接受了全面的经胸超声心动图检查和单点左颈总动脉（CCA）彩色多普勒动脉硬度检查。与 ABP 相比，SCI 患者的体重指数 (BMI) 和舒张压 (BP) 显着较低，在调整年龄、性别、BMI、体力活动和心率后，颈动脉硬度值显着较高（动脉顺应性较低）（P < 0.05）。 SCI患者右心室功能参数值较低（三尖瓣环平面收缩期偏移和右Sm；P<0.0001），室壁厚度增加，舒张功能受损。在7年的随访中，10.5%的SCI患者表现出高血压；在调整年龄和收缩压后，他们的体重明显增加，并且腹部肥胖有增加的趋势。 BMI被发现是高血压发展的独立预测因子。与 ABP 相比，患有创伤后慢性 SCI 且无明显心血管疾病的患者表现出更高的 CCA 硬度以及左心室和右心室受累。患有动脉高血压的截瘫患者表现出肥胖介导的 CCA 硬度增加。应提倡所有 SCI 患者改变生活方式和控制体重，即使是在非常早期的阶段。
The aim of this study was to compare arterial stiffness between people with paraplegia and able-bodied persons (ABPs) and to assess cardiovascular markers that may be predictive of the development of arterial hypertension in people with spinal cord injury (SCI). This study was conducted at rehabilitation Hospital, Udine (Italy). Fifty-seven patients with SCI were prospectively enrolled and compared with 88 healthy ABPs. All patients underwent comprehensive transthoracic echocardiography, and one-point left common carotid artery (CCA) color-Doppler study for arterial stiffness. Patients with SCI had significantly lower body mass index (BMI) and diastolic blood pressure (BP) compared with ABPs, and significantly higher carotid stiffness values (and lower arterial compliance) (P < 0.05) after adjustment for age, sex, BMI, physical activity, and heart rate. The SCI patients had lower values of the right ventricular function parameters (tricuspid annular plane systolic excursion and right Sm; P < 0.0001), increased wall thickness, and impaired diastolic function. At 7-year follow-up, 10.5% of SCI patients showed high BP; they were significantly heavier with a tendency toward increased abdominal obesity after adjustment for age and systolic BP. BMI was found to be an independent predictor of the development of hypertension. Patients with posttraumatic chronic SCI and no overt cardiovascular disease exhibit higher CCA stiffness along with the left and right ventricular involvement, compared with ABPs. People with paraplegia who develop arterial hypertension show increased CCA stiffness mediated by obesity. Lifestyle modifications and weight control should be promoted in all patients with SCI, even at a very early stage.