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首页> 外文期刊>American Journal of Physiology >Associations and clinical relevance of aortic-brachial artery stiffness mismatch, aortic reservoir function, and central pressure augmentation
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Associations and clinical relevance of aortic-brachial artery stiffness mismatch, aortic reservoir function, and central pressure augmentation

机译：主动脉 - 肱动脉僵硬失配，主动脉储层功能和中央压力增强的关联及临床相关性

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Central augmentation pressure (AP) and index (AIx) predict cardiovascular events and mortality, but underlying physiological mechanisms remain disputed. While traditionally believed to relate to wave reflections arising from proximal arterial impedance (and stiffness) mismatching, recent evidence suggests aortic reservoir function may be a more dominant contributor to AP and AIx. Our aim was therefore to determine relationships among aortic-brachial stiffness mismatching, AP, AIx, aortic reservoir function, and end-organ disease. Aortic (aPWV) and brachial (bPWV) pulse wave velocity were measured in 359 individuals (aged 61 ± 9, 49% male). Central AP, AIx, and aortic reservoir indexes were derived from radial tonometry. Participants were stratified by positive (bPWV > aPWV), negligible (bPWV ?* aPWV), or negative stiffness mismatch (bPWV < aPWV). Left-ventricular mass index (LVMI) was measured by two-dimensional-echocardiography. Central AP and AIx were higher with negative stiffness mismatch vs. negligible or positive stiffness mismatch (11 ± 6 vs. 10 ± 6 vs. 8 ± 6 mmHg, P < 0.001 and 24 ± 10 vs. 24 ± 11 vs. 21 ± 13%, P = 0.042). Stiffness mismatch (bPWV-aPWV) was negatively associated with AP (r = —0.18, P = 0.001) but not AIx (r = -0.06, P = 0.27). Aortic reservoir pressure strongly correlated to AP (r = 0.81, P < 0.001) and AIx (r = 0.62, P < 0.001) independent of age, sex, heart rate, mean arterial pressure, and height (standardized (3 = 0.61 and 0.12, P < 0.001). Aortic reservoir pressure independently predicted abnormal LVMI (P = 0.13, P — 0.024). Positive aortic-brachial stiffness mismatch does not result in higher AP or AIx. Aortic reservoir function, rather than discrete wave reflection from proximal arterial stiffness mismatching, provides a better model description of AP and AIx and also has clinical relevance as evidenced by an independent association of aortic reservoir pressure with LVMI.
机译：中央增强压力（AP）和索引（AIX）预测心血管事件和死亡率，但潜在的生理机制仍然有争议。虽然传统上据信涉及由近端动脉阻抗（和刚度）错配的波反射，但最近的证据表明主动脉储层功能可能是AP和AIX更具优势的贡献者。因此，我们的目的是确定主动脉肱僵硬不匹配，AP，AIX，主动脉储层功能和终端器官疾病的关系。在359个体中测量主动脉（APWV）和臂（BPWV）脉搏波速度（老化61±9,49％的男性）。中央AP，AIX和主动脉储存器指数来自径向正文。参与者由正（BPWV> APWV）分层，可忽略不计（BPWV？* APWV）或负刚度不匹配（BPWV

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