臂踝动脉脉搏波传导速度与左心室肥厚无明显相关

Brachial-ankle Pulse Wave Velocity and Left Ventricular Hypertrophy

目的探讨臂踝脉搏波传导速度(baPWV)与左心室肥厚(LVH)的关系。方法在浙江省东部沿海807名居民中,使用体积描记仪(欧姆龙-VP1000)测量baPWV,使用超声心电图测量左心室结构。以美国超声心动图学会推荐的标准定义LVH[左室质量/身高2.7≥51g/m2.7(男性)或者左室质量/身高2.7≥47g/m2.7(女性)]。结果LVH组的baPWV显著高于非LVH组[(15.3±3.3)比(13.3±2.5)m/s,P<0.01]。在807人中,没有调整其他心血管危险因素时,baPWV与左心室质量指数具有微弱相关性(r=0.19,P<0.01)。但在调整年龄和收缩压之后,二者之间的关联不再显著(r=-0.008,P=0.81)。在男性与女性中分别分析baPWV与LVH的关系,结果相似。在不调整其他心血管危险因素时,无论在男性(OR=1.30,P<0.01),还是女性(OR=1.19,P<0.05),随着baPWV的增高,LVH患病风险均增加(P<0.05)。但在调整年龄、收缩压以后,不论男性还是女性,二者的关联均未达到统计学显著性(P>0.05)。结论反映大动脉及肌性动脉硬化的baPWV与LVH之间的关联,在很大程度上和这两种亚临床病变形式共同的危险因素,如年龄、收缩压等有关。

Objective To study the relationship between brachial-ankle pulse wave velocity （baPWV） and left ventricular hypertrophy （LVH}. Methods BaPWV and LVH were measured in a cohort of 807 subjects in Zhejiang province. We used Omron VP-1000 and echocardiography to measure baPWV and left ventricular structure. LVH was defined according to the American Society of Echocardiograph criteria [left ventricular mass/height^2.7≥ g/m^2.7 （male） or left ventricular mass/height^2.7≥ g/m^2.7 （female）]. Results BaPWV in the LVH group was significantly higher than in the non-LVH group [ （ 15.3 ± 3.3 ） vs （ 13.3 ± 2.5 ） m/s, P± 0.01]. There was a weak but significant association between baPWV and left ventricular mass index（LVMI） （r= 0.19, P〈0.01）. However, after adjustment for sex, age and systolic blood pressure （SBP）, the association was nonsignificant. Analogously, after adjustment for age and SBP, logistic regression analysis showed the association between baPWV and LVH was nonsignificant either in men （P=0.34） or in women （P=0.31）. Conclusion The association between arterial stiffness as measured by baPWV and LVH is largely dependent on their associated risk factors, such as age and SBP.