Physiological and clinical insights from reservoir-excess pressure analysis.
Physiological and clinical insights from reservoir-excess pressure analysis.
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DOI：
10.1038/s41371-021-00515-6
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发表时间：
2021-09
影响因子：
2.7
通讯作者：
Sharman JE
中科院分区：
文献类型：
--
作者：
Armstrong MK;Schultz MG;Hughes AD;Picone DS;Sharman JE
越来越多的证据表明，储层-超压模型参数提供了超越标准血压(BP)和脉搏波形分析的生理和临床见解。这些信息从未被集体审查过，这也是本次审查的目的。心血管疾病是全球死亡的主要原因，其中BP是最大的心血管疾病风险因素。然而，臂动脉收缩压和舒张压提供的关于潜在血压波形的信息有限，遗漏了重要的与血压相关的心血管风险。通过储层-超压模型得到的参数提供了对BP波形的综合分析，这些参数包括储层压力、超压、收缩和舒张期速率常数和平稳性。这些参数来自动脉血压波形，提供了有关潜在的动脉生理和心室-动脉相互作用的信息，否则常规的血压和波形指数会忽略这些信息。在临床环境中应用储罐-超压模型可能有助于更好地理解和早期识别与疾病相关的心血管功能障碍。事实上，储罐超压参数与终末器官损害、心脏和血管功能障碍以及超出常规危险因素的未来心血管事件和死亡率的亚临床标记物相关。在未来，需要更多地了解储层超压参数的潜在生理学如何比传统的BP和波形指数更好地预测心血管疾病风险。此外，还应考虑使用嵌入传统BP评估方法的新技术，将储层-超压模型应用于临床实践。
There is a growing body of evidence indicating that reservoir-excess pressure model parameters provide physiological and clinical insights above and beyond standard blood pressure (BP) and pulse waveform analysis. This information has never been collectively examined and was the aim of this review. Cardiovascular disease is the leading cause of mortality worldwide, with BP as the greatest cardiovascular disease risk factor. However, brachial systolic and diastolic BP provide limited information on the underlying BP waveform, missing important BP related cardiovascular risk. A comprehensive analysis of the BP waveform is provided by parameters derived via the reservoir-excess pressure model, which include reservoir pressure, excess pressure, and systolic and diastolic rate constants and Pinfinity. These parameters, derived from the arterial BP waveform, provide information on the underlying arterial physiology and ventricular-arterial interactions otherwise missed by conventional BP and waveform indices. Application of the reservoir-excess pressure model in the clinical setting may facilitate a better understanding and earlier identification of cardiovascular dysfunction associated with disease. Indeed, reservoir-excess pressure parameters have been associated with sub-clinical markers of end-organ damage, cardiac and vascular dysfunction, and future cardiovascular events and mortality beyond conventional risk factors. In the future, greater understanding is needed on how the underlying physiology of the reservoir-excess pressure parameters informs cardiovascular disease risk prediction over conventional BP and waveform indices. Additional consideration should be given to the application of the reservoir-excess pressure model in clinical practice using new technologies embedded into conventional BP assessment methods.