updateonarterialstiffness大動脈僵硬研究進(jìn)展-免費閱讀
【正文】 113 :121325 Systolic pressure Pulse pressure arm aorta arm aorta 臨 床 問 題 ASCOT的 CAF201。 177。88:143148 方法 ? 46名志愿者 ， 禁食 、 臥床 ， 隨機(jī)給予安慰劑或不同劑量的緩釋 GTN貼劑 （ 毫克 /小時 ， /小時 ， /小時及 /小 時 ） ， 記錄橈動脈脈搏波并與傳統(tǒng)的袖帶血壓計測量結(jié)果對照 。 BODY MASS INDEX PWV is related to BMI (Adapted from TotoMoukouo et al., 1986) 19 21 23 25 27 29 31 33 35 37 Body mass index (kg/cm178。 Determinants of Arterial Stiffness pressure wall structure: vascular smooth muscle(VSM) cells, collagen fibers, and ground substance. Collagen greatly modifies arterial rigidity and the transit of wave reflections. Neurohumoral factors(RAS systems), may modulate collagen accumulation. Chemical modifications of collagen, such as breakdown, crosslinking, or glycation, result in marked changes in stiffness. 3. The function of endothelium Changes in VSM tone are modulated by nitric oxide (NO) and vasoconstrictive (norepinephrine, angiotensin, endothelin) pounds, which mainly depend on the function of endothelium. Amplitude of Earlier Wave Reflections mainly based on the geometry, number, structure, and function of smaller muscular arteries and arterioles which serve as major reflection sites ? or remodeling of small arteries and arterioles ? and branching angles of arterioles ? of the microenvironment (in particular sodium and other cations), ? endotheliummediated vasodilation, ? in matrix position of small arteries and arterioles, ? mediated alterations of vasomotor tone, arising from smooth muscle or endothelial cells. 動脈硬度與心血管危險 動脈硬度 ↑ 反射波強(qiáng)度 ↑ amp。Update on Arterial Stiffness 大動脈僵硬研究進(jìn)展 中國醫(yī)學(xué)科學(xué)院 阜外心血管病醫(yī)院 高血壓診治中心 蔣 雄 京 Definition of Blood Pressure ? In clinical practice, blood pressure is defined in terms of systolic and diastolic blood pressure, which represent the extremes of the blood pressure oscillation around a mean value, the MBP. In fact, the blood pressure curve may be considered as the summation of a steady ponent, MBP, and a pulsatile ponent, the pulse pressure (PP). From: O’ Rourke PULSE WAVE Principles Left ventricle ejection, which taking blood into the aorta, generates a pressure wave that is propagated to other arteries throughout the body. Propagation occurs along the arterial wall Systole . Blood = inpressible fluid Artery = elastic conduit } Radial waveform Ascending aortic waveform Female 18 years Female 48 years Female 97 years O’Rourke amp。 提前 +主動脈的緩沖能力 ↓ 收縮壓 ↑ 冠狀動脈灌注 ↓ 左室后負(fù)荷 ↑ 左室肥厚 ↑ 冠狀動脈缺血 amp。x10 4 ) 21 19 17 15 13 11 9 7 Pulse wave velocity (m/s) Nonobese Obese r = p BMI amp。 中心動脈 脈搏波通過已驗證的轉(zhuǎn)換函數(shù)從橈動脈脈搏波實時生成 。 177。研究發(fā)現(xiàn) CCB177。 ? 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)
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