Characterizing the relationship between flow-mediated vasodilation and radial artery tonometry in peripheral artery disease.
Characterizing the relationship between flow-mediated vasodilation and radial artery tonometry in peripheral artery disease.
复制标题
描述外周动脉疾病中血流介导的血管舒张与桡动脉张力测量之间的关系。
DOI：
10.1016/j.jss.2017.11.062
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发表时间：
2018
期刊：
影响因子：
--
通讯作者：
Grenon,SMarlene
中科院分区：
文献类型：
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作者：
Zahner,GregJ;Spaulding,KimberlyA;Ramirez,JoelL;Schaller,MelindaS;Walker,ShaneC;Hills,NancyK;Gasper,WarrenJ;Grenon,SMarlene
动脉僵硬和内皮功能障碍均与心血管事件的风险增加相关。动脉僵硬和内皮功能障碍均与心血管事件的风险增加有关。通过对123例血管外科门诊患者的横断面分析，在有动脉粥样硬化危险因素的对照组(n=32)和有动脉粥样硬化危险因素的患者(n=991)中，研究了FMD和AIX之间的关系。PAD定义为踝臂指数为0.9或有症状性PAD血运重建史的跛行症状。结果与对照组比较，PAD组≥明显降低(6.3%±33.8vsus8.4±33.7，P=0.0.008)，而正常化为75次/min的AIX值(25.5%±9.0vs19.3vs19.3%，P=0.001)和外周AIX值(91.34±914.5vsus81.3±11.4，P=0.001)明显升高。在整个队列中，FMD与中枢或外周AIX(中枢AIX：P=100.58；外周AIX：P=100.89)、PAD患者(中枢AIX：P=100.48；外周AIX：P=100.23)或对照组(中枢AIX：P=100.43；外周AIX：P=100.92)均无显著相关性。在包含FMD的多变量模型中，较高的AIX与PAD独立相关。结论在对血管外科门诊患者的分析中，未发现FMD与AIX之间的相关性。需要进行更大规模的前瞻性研究，以确定这两个参数的纳入是否会改善PAD患者早期识别和潜在风险分层的预测模型。
BackgroundArterial stiffness, measured by the augmentation index (AIX) from radial artery tonometry, and endothelial dysfunction, measured by brachial-artery flow-mediated vasodilation (FMD), have each been associated with increased risk of cardiovascular events. However, their interrelationship in peripheral artery disease (PAD) patients is poorly understood.Materials and methodsIn a cross-sectional analysis of 123 vascular surgery outpatients, the association between FMD and AIX was examined in controls with atherosclerotic risk factors (n= 32) and patients with PAD (n= 91). PAD was defined as claudication symptoms with an ankle-brachial index of <0.9 or a history of revascularization for symptomatic PAD. Controls had an ankle-brachial index ≥0.9 and no history of atherosclerotic vascular disease.ResultsCompared to controls, patients with PAD had lower FMD (6.3 ± 3.8versus8.4 ± 3.7,P= 0.008), while central AIX normalized to 75 beats per minute (25.5 ± 9.0versus19.3 ± 8.6,P= 0.001) and peripheral AIX (91.3 ± 14.5versus81.3 ± 11.4,P= 0.001) were higher. FMD was not significantly correlated with either central or peripheral AIX (central AIX:P= 0.58; peripheral AIX:P= 0.89) across the entire cohort, or in either the patients with PAD (central AIX:P= 0.48; peripheral AIX:P= 0.23) or controls (central AIX:P= 0.43; peripheral AIX:P= 0.92). In a multivariate model including FMD, higher AIX remained independently associated with PAD.ConclusionsIn an analysis of vascular surgery outpatients, no correlation between FMD and AIX was detected. Larger prospective studies are needed to determine whether the inclusion of both parameters improves predictive models for the early identification and potential risk stratification of PAD patients.