Carotid stiffening predicts cardiovascular risk stratification in mid-life: non-invasive quantification with ultrafast ultrasound imaging.
Carotid stiffening predicts cardiovascular risk stratification in mid-life: non-invasive quantification with ultrafast ultrasound imaging.
复制标题
颈动脉硬化可预测中年心血管风险分层：利用超快超声成像进行无创量化
DOI：
10.14366/usg.21197
复制
发表时间：
2022-07
期刊：
影响因子：
3.1
通讯作者：
Huang, Hui
中科院分区：
文献类型：
--
作者：
Zhu, Zhengqiu;Chen, Lingshan;Liu, Wenjun;Wu, Yiyun;Zou, Chong;Zhang, Xinyi;He, Shanshan;Wang, Yinping;Shen, Bixiao;Ma, Xuehui;Gao, Hui;Luan, Yun;Huang, Hui
关键词：
本研究利用超快速脉搏波速度（ufPWV）探讨了中年人群中系统性冠状动脉风险评估（SCORE）所估计的心血管风险与颈动脉僵硬度之间的关联。
这项研究招募了683名无已知心血管疾病或糖尿病的参与者，他们接受了ufPWV测量。对临床访谈、体格检查、实验室检查结果、颈动脉内膜 - 中层厚度（cIMT）、收缩期初的脉搏波速度（PWV - BS）以及收缩期末的脉搏波速度（PWV - ES）进行了评估。每位参与者根据主要心血管危险因素（CVRFs）进行了SCORE风险评估，这些危险因素包括年龄、性别、吸烟、收缩压（SBP）和总胆固醇（TC）。采用了粗优势比和调整后的优势比（ORs）以及95%置信区间和有序逻辑回归分析。对总体心血管危险因素进行了调整以评估优势比。
在性别亚组中，cIMT以及PWV - BS和PWV - ES中的颈动脉僵硬度存在显著差异（所有P < 0.05），但在年龄和SCORE估计风险亚组中，只有PWV - ES逐渐升高（所有P < 0.05）。与cIMT（r = 0.388，P < 0.001）和PWV - BS（r = 0.159，P < 0.001）相比，PWV - ES与SCORE类别相关性更强（r = 0.405，P < 0.001）。在中风险和高风险亚组中，较高的PWV - ES值与SCORE类别相关，且与性别、SBP、TC和吸烟无关（分别为OR，1.63；P < 0.001和OR，2.12；P = 0.024），但在所有风险亚组中与年龄并非无关（所有P > 0.05）。
通过ufPWV量化的颈动脉僵硬度与SCORE类别相关，升高的PWV - ES可能有助于心血管风险分层。
Purpose The present study investigated the association between Systematic COronary Risk Evaluation (SCORE)-estimated cardiovascular risk and carotid stiffening in a middle-aged population using ultrafast pulse wave velocity (ufPWV). Methods This study enrolled 683 participants without known cardiovascular disease or diabetes mellitus who underwent ufPWV measurements. Clinical interviews, physical examinations, laboratory findings, carotid intima-media thickness (cIMT), pulse wave velocity (PWV) at the beginning of systole (PWV-BS), and PWV at the end of systole (PWV-ES) were assessed. Each participant underwent an assessment of SCORE risk based on major cardiovascular risk factors (CVRFs), including age, sex, smoking, systolic blood pressure (SBP), and total cholesterol (TC). Crude and adjusted odds ratios (ORs) with 95% confidence intervals and ordinal logistic regression were used. Overall CVRFs were adjusted to assess ORs. Results cIMT and carotid stiffening in PWV-BS and PWV-ES were significantly different between sex subgroups (all P<0.05), but only PWV-ES increased gradually in age and SCORE-estimated risk subgroups (all P<0.05). Compared with cIMT (r=0.388, P<0.001) and PWV-BS (r=0.159, P<0.001), PWV-ES was more strongly correlated with SCORE categories (r=0.405, P<0.001). Higher PWV-ES values were associated with SCORE categories independently of sex, SBP, TC, and smoking in moderate-risk and high-risk subgroups (OR, 1.63; P<0.001 and OR, 2.12; P=0.024, respectively), but were not independent of age in all risk subgroups (all P>0.05). Conclusion Carotid stiffening quantified by ufPWV is linked to SCORE categories, and elevated PWV-ES may aid in cardiovascular risk stratification.