updateonarterialstiffness大動(dòng)脈僵硬研究進(jìn)展-wenkub
2022-09-12 14:25:03 本頁(yè)面
【正文】 ertension 2020。99:2434 ≤ PWV ≤ m/s ≤ PWV ≤ m/s （ PWV）較慢，反射波落在升主動(dòng)脈壓力波的舒張期（上圖）。 Nichols. McDonald’s Blood Flow in Arteries. Arnold, London 2020 20% BSP 300% APP 4x s 80 40 80 40 mmHg mmHg The pulsatile ponent, PP Determinants: 1. pattern of left ventricular ejection 2. cushioning capacity of aorta 3. the timing and intensity of wave reflections. arterial stiffness amp。 PP in subjects 50 years of age, ventricular ejection tends to be reduced, so that arterial stiffness and amplitude and timing of wave reflections bee the main determinants of increased SBP and PP. Question: Is arterial stiffness a marker of cardiovascular disease and mortality in the elderly? PWV amp。由于衰老動(dòng)脈硬度不斷增加， PWV加快，反射波提前產(chǎn)生，落在中心動(dòng)脈壓力波的收縮期而而主動(dòng)脈 舒張期壓力下降 （下圖） 。46:200204 血流 血流 Evaluation of arterial stiffness Surrogate Measures of arterial stiffness Pulse Wave Velocityamp。 Arnold Hodder 2020 PWV with age Reproduced from Avalio,et al. Change in contour and amplitude of pressure waves recorded in the radial artery and carotid in normal subjects between the first and eighth decade of life Disorders with great effects on arterial stiffness ? Hypertension ? Arteriosclerosisgeneralized degeneration of medial elements in elastic arteries ? Atherosclerosis ? Diabetes mellitus ? Premature aortic degeneration ? Obesity ? All these disorders result in artery stiffening. However, to some extent, the increased arterial stiffness are reversible by treatment. Pressure/diameter relationships show schematically for an elastic artery of a normal subject(left) and an agematched patient with hypertension(right) ARTERIAL STIFFNESS amp。 THERAPY Therapy for Arterial Stiffness Any antihypertensive drug that reduces mean arterial pressure results in passive decrease in arterial stiffness 從病理生理上已經(jīng)注意到動(dòng)脈僵硬是心血管事件重要的中心環(huán)節(jié)，那么動(dòng)脈僵硬度的降低是否比血壓降低更重要，能獨(dú)立預(yù)測(cè)心血管危險(xiǎn)的降低？ The goal of treatment for a selective increase in PP amp。s Clinic, University of New South Wales, Sydney, Australia ? Heart 2020。 咪達(dá)普利治療 6周后肱動(dòng)脈血壓變化與中心動(dòng)脈血壓變化的比較 肱動(dòng)脈 中心動(dòng)脈 P 收縮壓變化 (mmHg) 177。 脈壓變化 (mmHg) 反射波增壓變化 (mmHg) 177。 SUPERIOR EFFECT OF AN ANGIOTENSIN CONVERTING ENZYME INHIBITOR OVER A DIURETIC FOR REDUCING AORTIC SYSTOLIC PRESSURE J Hypertens. 2020 May。 ? St Vincent’s Clinic, UNSW, Sydn Patient characteristics at baseline Placebo (n=119) Felodipine (n=121) p value Height (cm) + + Weight (kg) + + Age (years) + + Brachial SP (mmHg) + + Brachial DP (mmHg) + + Mean pressure (mmHg) + + Heart rate (bpm) + + Aortic SP (mmHg) + + Aortic DP (mmHg) + +
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