NONINVESIVE ASSESSMENT OF VASCULAR ENDOTHELIAL. FUNCTION BY MEANS OF THE CHANGE IN PULSE CONDUCTION VEROCITY WITH FLOW MEDIATED DILATION

我们开发了一种新的方法，通过血流介导的扩张（FMD）的脉搏波传导速度的变化来无创评估血管内皮功能。尽管FMD作为一种无创性的血管内皮功能指标正受到人们的关注，但使用血管超声成像的传统评估具有严重的局限性，例如伴随血管直径超声测量的伪影和血管直径的生理自发波动，这妨碍了FMD在一般临床实践中的分布。FMD的发生与脉搏波传导速度的降低有关，表现为血管直径的增大，血管壁的厚度和弹性的降低。因此，我们用臂袖法检测了缺血5分钟引起的反应性充血引起的FMD时脉搏波传导速度的变化。与正常对照组相比，FMD时脉搏波传导速度的变化较小。结果表明，FMD时脉搏波传导速度的变化与缺血5分钟引起的反应性充血引起的FMD时脉搏波传导速度的变化有关。FMD时脉搏波传导速度的变化与缺血5分钟引起的FMD时脉搏波传导速度的变化有关。FMD时脉搏波传导速度的变化与缺血 ...更多信息 该方法还可排除体血压、心率和自主神经活动变化对脉搏波传导速度的影响。我们制作了一个仪器的原型，并测量了120名受试者，包括健康人和高血压和冠心病患者的脉搏波传导速度的FMD相关的变化。脉搏波传导速度在手臂袖带释放后表现出短暂的降低，峰值反应发生在释放后约1分钟。这种反应类似于那些被称为FMD的反应。反应的幅度随着年龄的增长而降低，并且在高血压和冠状动脉疾病患者中降低。舌下含服硝酸甘油后，上述反应消失。这些观察结果表明，我们的方法是潜在的有用的评估血管内皮功能。然而，我们的方法的临床应用需要改进脉搏波传感器和用于测量脉搏波传导时间的软件。少

We developed a novel method for noninvasive assessment of vascular endothelial function by means of the changes in pulse wave conduction velocity with flow mediated dilation (FMD). Although FMD is gathering attention as a noninvasive index of vascular endothelial function, conventional assessment using vascular ultrasound imaging has serious limitations, such as artifact accompanying the ultrasound measurement of vascular diameter and physiological spontaneous fluctuations in vascular diameter, which preclude the distribution of FMD in general clinical practice. FMD is accompanied by reduction in pulse wave conduction velocity through an increase in vascular diameter and a decrease in the thickness and elasticity of the vascular wall We therefore tried to detect the changes in pulse wave conduction velocity with FMD induced by reactive hyperemia caused by 5-min ischemia with an arm-cuff on an arm. Small changes in pulse wave conduction velocity were detected with contrasting to the pul … More se wave conduction velocity in the lateral arm. The influences of the changes in systemic blood pressure, heart rate and autonomic neural activity on pulse wave conduction velocity could be also excluded by this method. We made a prototype of the instrument and measured the FMD-related changes in pulse wave conduction velocity in 120 subjects including healthy people and patients with hypertension and coronary artery diseases. The pulse wave conduction velocity showed a transient decrease after release of the arm cuff with the peak response occurring about 1 min after the release. The response resembled to those known as FMD. The magnitude of the response was decreasing with age and reduced in patients with hypertension and those with coronary artery disease. Furthermore, the response disappeared after sublingual nitroglycerin. These observations indicate that our method is potentially useful assessment of vascular endothelial function. The clinical application of our method, however, requires refinement of the pulse wave sensor and software for measurement of pulse wave conduction time. Less