Reply to ‘Known unknowns of sex differences in cardiovascular physiology ? can arterial waveforms provide answers?’
Reply to ‘Known unknowns of sex differences in cardiovascular physiology ? can arterial waveforms provide answers?’
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回复“心血管生理学中性别差异的已知未知数？动脉波形可以提供答案吗？”
DOI：
10.1097/hjh.0000000000003146
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发表时间：
2022
影响因子：
4.9
通讯作者：
Junichiro Hashimoto
中科院分区：
文献类型：
--
作者：
Kaname Tagawa;Junichiro Hashimoto
我们感谢Picone等人。[1]因为他们对我们最近的文章感兴趣[2]。在我们最近的文章中，我们证明了女性主动脉舒张压下降加速，并介导了性别和内膜下存活率（SEVR）之间的关系。考虑到最近对中心血流动力学的临床评估主要基于收缩压轮廓（例如增强指数）[3，4]，我们的研究结果显示舒张压轮廓的重要性，可能会发现冠心病预防的新靶点[5]。[1]指出，与有创测量相比，无创测量的SEVR可能被高估[6]。无创测量的SEVR不能解释心室内舒张压以及左心室等长收缩和舒张的收缩期和舒张末期的适当分配[7]。然而，无创测量的SEVR与左心室内膜下与心外膜下血流比具有较高的相关系数（0.85）[8]。此外，无创性主动脉舒张压衰减指数似乎与有创性无差异[7]。也就是说，在我们的研究中使用的SEVR和主动脉舒张压衰减指数的无创评估是有效的，我们的文章提供了直接的证据表明，女性心肌缺血的易感性是由于舒张压衰减加速。
We thank Picone et al.[1] for their interest in our recent article [2]. In our recent article, we demonstrated that aortic diastolic pressure decay is accelerated in women and mediates the relationship between sex and subendocardial viability ratio (SEVR). Considering that recent clinical assessments of central hemodynamics are based mainly on systolic pressure contour (eg augmentation index)[3, 4], our findings showing the importance of diastolic pressure contour might identify novel targets for coronary heart disease prevention [5].As Picone et al.[1] pointed out, the SEVR measured noninvasively may be overestimated compared with that measured invasively [6]. A noninvasively measured SEVR does not account for the intraventricular diastolic pressure and proper allocation to systole and diastole of left ventricular isometric contraction and relaxation, respectively [7]. However, a noninvasively measured SEVR has a high correlation coefficient (0.85) with left ventricular subendocardial to subepicardial blood flow ratio [8]. Moreover, a noninvasive aortic diastolic pressure decay index appears to be no different from an invasive one [7]. Namely, the noninvasive assessments of SEVR and aortic diastolic pressure decay index used in our study are valid and our article provides direct evidence that the predisposition to myocardial ischemia in women is attributable to accelerated diastolic pressure decay.