Arterial Stiffness and Cardiorespiratory Fitness Impairment in the Community.
Arterial Stiffness and Cardiorespiratory Fitness Impairment in the Community.
复制标题
DOI：
10.1161/jaha.123.029619
复制
发表时间：
2023-11-07
影响因子：
5.4
通讯作者：
中科院分区：
文献类型：
--
作者：
在运动过程中，健康的动脉系统有助于增加血流量，并将其有效地分配到重要器官。因此，我们试图了解动脉硬化如何损害社区居民的心肺适应性。对心脏瓣膜研究参与者（N=2898，年龄54±9岁，53%为女性，体重指数28.1±5.3 kg/m2）进行动脉张力测定和最大努力心肺运动试验。我们将5个动脉僵硬度指标（颈动脉-股动脉脉搏波速度[CFPWV]：主动脉壁僵硬度的指标;中心脉压、前向波振幅、特征阻抗：压力脉动性的指标;增强指数：相对波反射的指标）与多维运动反应相关，使用线性模型调整年龄、性别、静息心率、习惯性体力活动和临床风险因素。较高的CFPWV、增强指数和特征阻抗与较低的峰值摄氧量（VO 2;均P<0.0001）相关。我们观察到不同年龄、性别和心血管风险特征的CFPWV与峰值摄氧量的相关性（交互作用P>0.05）。然而，肥胖个体的CFPWV-峰值摄氧量关系减弱（肥胖 *CFPWV相互作用P=0.002）。较高的CPFWV、增强指数和特征阻抗也与心肺运动试验指标相关，反映了不利的O2动力学和较低的每搏输出量和外周O2提取，但与舒张效率无关，这是右心室-肺血管性能的预后指标。我们的研究结果描绘了社区居民个体的动脉硬度和心肺功能的关系。未来的研究是必要的，以评估是否涉及的生理措施，这里可能代表潜在的目标，改善心肺功能在一般人群。
During exercise, a healthy arterial system facilitates increased blood flow and distributes it effectively to essential organs. Accordingly, we sought to understand how arterial stiffening might impair cardiorespiratory fitness in community‐dwelling individuals. Arterial tonometry and maximum effort cardiopulmonary exercise testing were performed on Framingham Heart Study participants (N=2898, age 54±9 years, 53% women, body mass index 28.1±5.3 kg/m2). We related 5 arterial stiffness measures (carotid‐femoral pulse wave velocity [CFPWV]: a measure of aortic wall stiffness; central pulse pressure, forward wave amplitude, characteristic impedance: measures of pressure pulsatility; and augmentation index: a measure of relative wave reflection) to multidimensional exercise responses using linear models adjusted for age, sex, resting heart rate, habitual physical activity, and clinical risk factors. Greater CFPWV, augmentation index, and characteristic impedance were associated with lower peak oxygen uptake (VO2; all P<0.0001). We observed consistency of associations of CFPWV with peak oxygen uptake across age, sex, and cardiovascular risk profile (interaction P>0.05). However, the CFPWV‐peak oxygen uptake relation was attenuated in individuals with obesity (P=0.002 for obesity*CFPWV interaction). Higher CPFWV, augmentation index, and characteristic impedance were also related to cardiopulmonary exercise testing measures reflecting adverse O2 kinetics and lower stroke volume and peripheral O2 extraction but not to ventilatory efficiency, a prognostic measure of right ventricular‐pulmonary vascular performance. Our findings delineate relations of arterial stiffness and cardiorespiratory fitness in community‐dwelling individuals. Future studies are warranted to evaluate whether the physiological measures implicated here may represent potential targets for improving cardiorespiratory fitness in the general population.