早期舒张性心力衰竭中Ang Ⅱ与踝臂脉搏波传导速度的关系

Relationship between brachial-ankle pulse wave velocity and angiotensin Ⅱ in early mild diastolic heart failure

目的评估血管紧张素Ⅱ（angiotensinⅡ,AngⅡ）与踝臂脉搏波传导速度（brachial-ankle pulse wave velocity,ba PW V）在早期舒张性心力衰竭（early m ild diastolic heart failure,early m ild DHF）中的关系。方法于2012年7月初至8月底选取上海市陆家嘴社区自然人群1 082例作为研究对象,从中以年龄和性别为匹配因素,选取55例为对照组;以相关系数评估ba PWV与AngⅡ的相关性强度;以二分类logistic回归分析评估早期舒张性心力衰竭相关的独立危险因素。结果早期舒张性心力衰竭组与正常组相比,舒张早期二尖瓣血流速度与舒张晚期二尖瓣血流速度比值（E/A）、舒张早期二尖瓣血流速度与舒张早期二尖瓣环运动速度的比值（E/e’）、AngⅡ差异有统计学意义。简单相关性分析显示,AngⅡ与踝臂脉搏波传导速度呈线性相关关系（r=0.325,P=0.015〈0.05）。在调整AngⅡ、体质量指数、中心动脉压、动脉硬化指数、踝臂指数、脉压差、踝臂脉搏波传导速度、脑钠肽后与早期舒张性心力衰竭独立相关的变量是AngⅡ（OR=4.08,P=0.002,95%CI：1.65~10.10）。结论 AngⅡ是早期舒张性心力衰竭的独立危险因素;AngⅡ与踝臂脉搏波传导速度具有中等强度的相关性。

Objective To investigate the relationship between brachial-ankle pulse wave velocity （baPWV） and angiotensin Ⅱ （Ang Ⅱ ） in early mild diastolic heart failure （DHF）. Methods One thousand and eighty-two patients with early mild diastolic heart failure and 55 age and gender-matched healthy subjects were enrolled from Shanghai Lujiazui community from July 2012 to August 2012. baPWV and serum Ang Ⅱ were measured. The association between BAPWV and angiotensin Ⅱ was analyzed with simple correlation analysis and the risk factors of heart failure was analyzed with binary logistic-regression method. Results There were significant differences in E/A, E/e＇ and Ang Ⅱlevels between DHF and control groups （P 〈 0. 05 ）. Ang Ⅱ was significantly correlated with the baPWV（r=0.325,P=0. 015）. After adjusting the Ang II, BMI , CBP, AI, ABI, PP, BAPWV and BNP, Binary logistic-regression analysis indicated that Ang Ⅱ was strongly associated with early mild DHF（ OR = 4.08, P = 0. 002,95 % CI： 1.65 - 10. 10）. Conclusion Ang Ⅱ is an independent risk factor of DHF, which is significantly correlated with baPWV.