Forearm vascular reactivity and arterial stiffness in asymptomatic adults from the community
Forearm vascular reactivity and arterial stiffness in asymptomatic adults from the community
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DOI：
10.1161/hypertensionaha.107.106088
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发表时间：
2008-06-01
期刊：
影响因子：
8.3
通讯作者：
Kullo, Iftikhar J.
中科院分区：
文献类型：
--
作者：
Malik, A. Rauoof;Kondragunta, Venkateswarlu;Kullo, Iftikhar J.
血管反应性可影响动脉壁的硬度特性。我们调查了527名无心血管疾病的无症状非西班牙裔白色成年人前臂微循环和管道动脉功能与动脉硬度测量之间的关系。对肱动脉（ba）进行高分辨率超声检查，以评估前臂微循环功能（静息和反应性充血时的ba血流速度、局部剪切应力和前臂血管阻力）和管道动脉功能（ba血流介导的扩张[baFMD]和ba硝酸甘油介导的扩张[baNMD]）。动脉僵硬度通过袖带肱动脉脉压和压平张力计测量的主动脉脉搏波速度（aPWV）进行评估。在校正心率、平均动脉压、身高、心血管危险因素、高血压药物和他汀类药物使用的回归分析中，较高的基线ba收缩期流速和收缩期切应力与较高的脉压（分别为P = 0.0002和P = 0.006）和较高的aPWV（均P < 0.0001）相关。充血时，较低的ba平均流速和较低的平均切应力与较高的脉压相关（分别为P = 0.045和P = 0.036），而收缩期和平均流速收缩压和平均切应力（分别为P <0.0001和P = 0.003）与aPWV呈负相关。baFMD与脉压无关，但与aPWV呈负相关（P = 0.011）。baNMD与脉压（P = 0.0002）和aPWV（P = 0.008）呈负相关。我们的研究结果表明，前臂微血管功能受损（以静息血流速度升高和血流储备受损的形式）和肱动脉反应性受损与动脉僵硬度增加相关。
Vascular reactivity may affect the stiffness characteristics of the arterial wall. We investigated the association between forearm microcirculatory and conduit artery function and measures of arterial stiffness in 527 asymptomatic non-Hispanic white adults without known cardiovascular disease. High-resolution ultrasonography of the brachial artery (ba) was performed to assess forearm microcirculatory function (ba blood flow velocity, local shear stress, and forearm vascular resistance at rest and during reactive hyperemia) and conduit artery function (ba flow-mediated dilatation [baFMD] and ba nitroglycerin-mediated dilatation [baNMD]). Arterial stiffness was assessed by cuff-derived brachial pulse pressure and aortic pulse wave velocity (aPWV) measured by applanation tonometry. In regression analyses that adjusted for heart rate, mean arterial pressure, height, cardiovascular risk factors, and hypertension medication and statin use, higher baseline ba systolic velocity and systolic shear stress were associated with greater pulse pressure (P = 0.0002 and P = 0.006, respectively) and higher aPWV (each P < 0.0001). During hyperemia, lower ba mean velocity and lower mean shear stress were associated with higher pulse pressure (P = 0.045 and P = 0.036, respectively), whereas both systolic and mean velocity (P < 0.0001 and P = 0.002, respectively) and systolic and mean shear stress (P < 0.0001 and P = 0.003, respectively) were inversely associated with aPWV. baFMD was not associated with pulse pressure but was inversely associated with aPWV (P = 0.011). baNMD was inversely associated with pulse pressure (P = 0.0002) and aPWV (P = 0.008). Our findings demonstrate that impaired forearm microvascular function (in the form of elevated resting blood flow velocity and impaired flow reserve) and impaired brachial artery reactivity are associated with increased arterial stiffness.