Ventricular wall stress and silent myocardial damage are associated with pulse pressure in the general population.
Ventricular wall stress and silent myocardial damage are associated with pulse pressure in the general population.
复制标题
心室壁应力和无症状心肌损伤与一般人群的脉压相关。
DOI：
10.1111/jch.13349
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发表时间：
2018
期刊：
影响因子：
--
通讯作者：
Watanabe M.
中科院分区：
文献类型：
--
作者：
Takahashi T;Shishido T;Watanabe K;Sugai T;Toshima T;Kinoshita D;Yokoyama M;Tamura H;Nishiyama S;Takahashi H;Arimoto T;Miyamoto T;Watanabe T;Shibata Y;Konta T;Ueno Y;Kato T;Kayama T;Kubota I;Watanabe M.
脉压（PP）是心血管疾病的危险因素，与后负荷和心肌需氧量增加有关。脑利钠肽（BNP）和心脏型脂肪酸结合蛋白（H-FABP）被认为是指示心室壁应力和无症状心肌损伤的生物标志物。然而，PP与心室壁应力和一般人群中无症状心肌损伤之间的关系尚不清楚。作者招募了3504名参与社区年度健康检查的患者。测量BNP和H-FABP的血清水平作为心室壁应力和无症状心肌损伤的标志物。根据PP的四分位数将患者分为四组。PP最高组患者的血清BNP和H-FABP水平高于其他组。多变量logistic分析显示，基于BNP和H-FABP水平，高PP与室壁应力和无症状心肌损伤独立相关。与收缩压、舒张压和平均血压相比，PP在预测BNP和H-FABP水平评价的室壁应力和无症状心肌损害方面具有上级优势，这一点在受试者工作特征分析中得到了反映。对健康患者的筛查显示，高PP与高BNP和H-FABP水平相关，这表明无症状的高PP一般人群可能暴露于心室壁应力和心肌损伤，可能易患无症状心力衰竭。
Pulse pressure (PP) is a risk factor for cardiovascular diseases and is associated with increased afterload and myocardial oxygen demand. Brain natriuretic peptide (BNP) and heart‐type fatty acid–binding protein (H‐FABP) are known as biomarkers indicating ventricular wall stress and silent myocardial damage. However, the association between PP and ventricular wall stress and silent myocardial damage in the general population is unclear. The authors enrolled 3504 patients who participated in a community‐based annual health check. Serum levels of BNP and H‐FABP were measured as markers of ventricular wall stress and silent myocardial damage. Patients were divided into four groups according to the quartiles of PP. Patients in the highest PP group showed higher serum BNP and H‐FABP levels than that of the other groups. Multivariate logistic analysis showed that high PP was independently associated with ventricular wall stress and silent myocardial damage on the basis of BNP and H‐FABP levels. Compared with systolic blood pressure, diastolic blood pressure, and mean blood pressure, PP was superior in predicting ventricular wall stress and silent myocardial damage evaluated according to BNP and H‐FABP levels, which was reflected by the receiver operating characteristic analysis. Screening of healthy patients revealed that high PP was related to high BNP and H‐FABP levels, suggesting that an asymptomatic general population with high PP may be exposed to ventricular wall stress and myocardial damage and might be susceptible to silent heart failure.