Percutaneous transluminal angioplasty for peripheral artery disease confers cardiorenal protection
Percutaneous transluminal angioplasty for peripheral artery disease confers cardiorenal protection
复制标题
经皮腔内血管成形术治疗外周动脉疾病可提供心肾保护
DOI：
10.1038/jhh.2013.37
复制
发表时间：
2014
期刊：
影响因子：
2.7
通讯作者：
Kario K
中科院分区：
文献类型：
--
作者：
Eguchi K;Murakami A;Horaguchi T;Kato M;Miyashita H;Kario K
经皮腔内血管成形术（PTA）对血流动力学参数的影响尚未确定。我们检验了PTA可降低外周动脉疾病（PAD）患者血流动力学和靶器官损伤（TOD）指标的假设。我们入组了56例计划接受择期PTA手术的连续PAD患者。在基线和随访时评估肱动脉血压（BP）、中心血压、左心室质量指数（LVMI）和尿微量白蛋白排泄率（UACR）。PTA后患侧踝臂指数明显改善（P< 0.001）。与治疗前水平相比，PTA后肱动脉和中心动脉血压、颈动脉增强指数（AI）和中心动脉增强压（AP）、LVMI和UACR均显著降低。PTA组AI的变化与LVMI的变化程度显著相关（P= 0.002），与UACR的变化轻微相关（P= 0.07），独立于其他协变量。总之，在PAD患者中，通过PTA治疗观察到颈动脉AI显著降低;这些变化可能归因于心脏和肾脏靶器官损伤指标的改善。
The effects of percutaneous transluminal angioplasty (PTA) on hemodynamic parameters are not established. We tested the hypothesis that PTA would achieve reductions in hemodynamic and target organ damage (TOD) measures in patients with peripheral artery disease (PAD). We enrolled 56 consecutive PAD patients who were scheduled to undergo elective PTA procedures. Brachial blood pressure (BP), central BP, left ventricular mass index (LVMI) and urinary microalbumin excretion ratio (UACR) were assessed at baseline and follow-up. The ankle–brachial index in the diseased leg significantly improved after the PTA (P< 0.001). Compared with the pretreatment levels, brachial and central BPs, the carotid augmentation index (AI) and central augmentation pressure (AP) were significantly reduced after the PTA, as were LVMI and UACR. The change in AI in the PTA group was significantly associated with the extent of change in LVMI (P= 0.002) and marginally associated with the change in UACR (P= 0.07), independently of other covariates. In conclusion, in patients with PAD, significant reductions in carotid AI were observed by PTA treatment; these changes may be attributable to improvements in measures of cardiac and renal target organ damage.