RELATION OF ARTERIAL-PRESSURE WAVE-FORM TO LEFT-VENTRICULAR AND CAROTID ANATOMY IN NORMOTENSIVE SUBJECTS
RELATION OF ARTERIAL-PRESSURE WAVE-FORM TO LEFT-VENTRICULAR AND CAROTID ANATOMY IN NORMOTENSIVE SUBJECTS
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DOI：
10.1016/0735-1097(93)90772-s
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发表时间：
1993-12-01
影响因子：
24
通讯作者：
DEVEREUX, RB
中科院分区：
文献类型：
--
作者：
SABA, PS;ROMAN, MJ;DEVEREUX, RB
目标。本研究的目的是研究中心动脉压力波形与左心室和颈动脉结构的关系。中央动脉的压力波形受到来自外围的压力波反射的影响。当反射波在收缩时与入射波合并时，观察到收缩末期峰值和收缩压升高。随之而来的血流动力学负荷的增加可能会刺激左心室和血管的适应性变化。对67名血压正常的成人进行了无创性技术研究。超声检查左心室和颈动脉的解剖和功能。应用外眼压仪记录颈动脉压力波形，用最大收缩压与拐点最大收缩压之差除以脉压，以增大指数表示波形。受试者被分配到具有显性早期收缩峰值(组1，增大指数小于或等于0)或显性晚期收缩峰值(组2，增大指数<0)的组。2组的左心室重量指数显著高于1组，在控制了性别、年龄和血压的混杂影响后，这种差异仍然存在。颈动脉壁厚度和局部动脉硬度在第2组显著增加，但在年龄协方差分析中差异消失。左心室和颈动脉的结构与中心压波形的形状有关。虽然在收缩末期峰值压力占主导地位的受试者中，左心室质量的增加似乎与压力波形的形状直接相关，但颈动脉结构和物理特性的变化似乎与衰老过程更密切相关。
Objectives. The purpose of this study was to examine the relation of the central arterial pressure waveform to left ventricular and carotid structure.Background. The pressure waveform in the central arteries is affected by reflection of the pressure wave from the periphery. When reflected waves merge with the incident wave during systole, a late systolic peak and increment in systolic blood pressure are observed. The consequent increase in hemodynamic load may stimulate left ventricular and vascular adaptive changes.Methods. Sixty seven normotensive adults were studied by noninvasive techniques. Anatomy and function of the left ventricle and carotid artery were investigated by ultrasonography. Pressure waveforms were recorded by an external tonometer applied to the carotid artery, and waveform shape was expressed by the augmentation index, calculated from the difference between the maximal systolic pressure and that at the inflection between early and late systolic pressure peaks divided by the pulse pressure. Subjects were assigned to groups with a dominant early (group 1, augmentation index less than or equal to 0) or dominant late systolic peak (group 2, augmentation index > 0).Results. Left ventricular mass index was significantly higher in group 2 than in group 1, a difference that persisted after controlling for the confounding effects of gender, age and blood pressure. Carotid wall thickness and regional arterial stiffness were significantly increased in group 2, but differences disappeared in the analysis of covariance for age.Conclusions. Left ventricular and carotid artery structure are related to the shape of the central pressure waveform. Although the increase in left ventricular mass seen in subjects with a dominant late systolic peak pressure appears to be directly related to the shape of the pressure waveform, changes in the structural and physical properties of the carotid artery appear to be more closely related to the aging process.