AIM: To characterize hydraulic right ventricle (RV) af- terload by pulmonary arterial pressure waveform analy- sis in an acute pulmonary hypertension (PH) model. METHODS: Pulmonary artery (PA) flow and pressure were r...AIM: To characterize hydraulic right ventricle (RV) af- terload by pulmonary arterial pressure waveform analy- sis in an acute pulmonary hypertension (PH) model. METHODS: Pulmonary artery (PA) flow and pressure were recorded in six anesthetized sheep. Acute iso- baric PH was induced by phenylephrine (active) and PA mechanical constriction (passive). We estimated the amplitude of the forward and reflected pressure waves according to the inflection point. In most cases the in- flection pressure was smooth, thus the inflection point was defined as the time at which the first derivative ofpulmonary arterial pressure reached its first minimum. We calculated the input and characteristic (Z C , time- domain Li method) impedances, the capacitance index (stroke volume/pulse pressure), the augmentation index (AI) (reflected pressure/pulse pressure), the frac- tional pulse pressure (pulse pressure/mean pressure) and the wasted energy generated by the RV due to wave reflection during ejection (E W ). RESULTS: Pulse pressure, fractional pulse pressure, AI and Z C increased and capacitance index decreased during passive PH with respect to control (P < 0.05). In contrast, Z C and the capacitance index did not change and E W and the AI decreased during active PH. Pulse pressure correlated with E W and Z C and the AI was cor- related with E W (r > 0.6, P < 0.05). CONCLUSION: PA pressure waveform analysis al- lows the quantification of the dynamic RV afterload. Prospective clinical studies will be necessary to validate this time-domain approach to evaluate the dynamic RV afterload in chronic PH.展开更多
目的反射波增强指数(AI)是反映动脉反射波的一个指标。在老年人中,AI 是否是反映动脉硬化的一个较好指标,目前存在争议。为了更好地理解在老年人中运用 AI 的意义,我们在～老年人群中研究 AI 的影响因素。方法在上海青浦区赵巷镇选择70...目的反射波增强指数(AI)是反映动脉反射波的一个指标。在老年人中,AI 是否是反映动脉硬化的一个较好指标,目前存在争议。为了更好地理解在老年人中运用 AI 的意义,我们在～老年人群中研究 AI 的影响因素。方法在上海青浦区赵巷镇选择70岁以上老年人,用 Omron 公司 HEM9000 AI 脉波检测仪进行左侧桡动脉脉搏波分析,心率取校正到75次/min 的 AI 进行统计分析。结果1286例受检者中包括761名(59%)女性,815例(63%)高血压病患者。平均年龄为76.3岁。女性的 AI 显著高于男性(90.3%vs 85.8%,P<0.01)。简单相关分析显示:不论男女,AI(P<0.05)都随着年龄的增加而升高,随身高和血糖水平的增加而降低。男性饮酒者的 AI 显著高于不饮酒者(87.3%vs 85.2%,P=0.03)。多元逐步回归分析显示:身高、平均动脉压和空腹血糖是女性 AI 的独立影响因素。在男性,AI 还受年龄和饮酒的影响。结论在70岁以上老年人中,年龄、性别、身高、平均动脉压和血糖水平是 AI 的独立影响因素。展开更多
目的观察厄贝沙坦对脉压(PP)≥60 mm Hg(1 mm Hg=0．133 kPa)高血压患者的动脉弹性功能、反射波及PP的影响。方法选取符合入选条件的原发性高血压患者30例,男13例、女17例,平均年龄为(65．2±8．5)岁(51～83岁),随机分成治疗组和对...目的观察厄贝沙坦对脉压(PP)≥60 mm Hg(1 mm Hg=0．133 kPa)高血压患者的动脉弹性功能、反射波及PP的影响。方法选取符合入选条件的原发性高血压患者30例,男13例、女17例,平均年龄为(65．2±8．5)岁(51～83岁),随机分成治疗组和对照组,分别给予厄贝沙坦(150 mg/d)和安慰剂治疗3个月。结果与治疗前相比,对照组治疗后中心和肱动脉收缩压、舒张压及PP轻度下降,但差异无显著性(P＞0．05)；而治疗组显著下降(P＜0．05),治疗组的降幅均显著高于对照组(P值分别＜0．05和0．01)。治疗后,治疗组的反射波增强压(AP)和增强指数(A1)明显下降(P＜0．01),颈-股动脉脉搏波传导速度(CF-PWV)显著变慢(P＜0．01),降幅显著高于对照组；大、小动脉弹性功能指数(Cl、C_2)值均显著增加(P值分别＜0．05和0．01),增幅显著高于对照组。分别以C_1和CF-PWV变化为应变量,收缩压、舒张压降幅为自变量行多元线形回归分析,决定系数(R2)为0．486及0．384(P＜0．05)。结论厄贝沙坦可明显改善PP≥60mm Hg高血压患者的大、小动脉弹性,减弱外周波反射,缩小PP。展开更多
目的观察原发性高血压(essential hypertension,EH)患者桡动脉反射波增强指数(radialartery augmenta-tion index of reflected wave,rAI)的变化,探讨血压与rAI之间的关系。方法分别测定120例血压正常的健康者和120例EH患者(按照血压的...目的观察原发性高血压(essential hypertension,EH)患者桡动脉反射波增强指数(radialartery augmenta-tion index of reflected wave,rAI)的变化,探讨血压与rAI之间的关系。方法分别测定120例血压正常的健康者和120例EH患者(按照血压的不同分为EH1级组、EH2级组、EH3级组,每组各40例)的rAI值。结果 rAI值:对照组<EH1级组<EH2级组<EH3级组,4组间差异均有统计学意义(P<0.05)。结论 rAI随血压的增高而升高,检测rAI有助于早期发现高血压动脉弹性功能的变化,是反映高血压动脉僵硬度的可靠指标。展开更多
基金Supported by Comisión Sectorial de Investigación Científica,Universidad de la República and Programa de Desarrollo de las Ciencias Básicas
文摘AIM: To characterize hydraulic right ventricle (RV) af- terload by pulmonary arterial pressure waveform analy- sis in an acute pulmonary hypertension (PH) model. METHODS: Pulmonary artery (PA) flow and pressure were recorded in six anesthetized sheep. Acute iso- baric PH was induced by phenylephrine (active) and PA mechanical constriction (passive). We estimated the amplitude of the forward and reflected pressure waves according to the inflection point. In most cases the in- flection pressure was smooth, thus the inflection point was defined as the time at which the first derivative ofpulmonary arterial pressure reached its first minimum. We calculated the input and characteristic (Z C , time- domain Li method) impedances, the capacitance index (stroke volume/pulse pressure), the augmentation index (AI) (reflected pressure/pulse pressure), the frac- tional pulse pressure (pulse pressure/mean pressure) and the wasted energy generated by the RV due to wave reflection during ejection (E W ). RESULTS: Pulse pressure, fractional pulse pressure, AI and Z C increased and capacitance index decreased during passive PH with respect to control (P < 0.05). In contrast, Z C and the capacitance index did not change and E W and the AI decreased during active PH. Pulse pressure correlated with E W and Z C and the AI was cor- related with E W (r > 0.6, P < 0.05). CONCLUSION: PA pressure waveform analysis al- lows the quantification of the dynamic RV afterload. Prospective clinical studies will be necessary to validate this time-domain approach to evaluate the dynamic RV afterload in chronic PH.
文摘目的反射波增强指数(AI)是反映动脉反射波的一个指标。在老年人中,AI 是否是反映动脉硬化的一个较好指标,目前存在争议。为了更好地理解在老年人中运用 AI 的意义,我们在～老年人群中研究 AI 的影响因素。方法在上海青浦区赵巷镇选择70岁以上老年人,用 Omron 公司 HEM9000 AI 脉波检测仪进行左侧桡动脉脉搏波分析,心率取校正到75次/min 的 AI 进行统计分析。结果1286例受检者中包括761名(59%)女性,815例(63%)高血压病患者。平均年龄为76.3岁。女性的 AI 显著高于男性(90.3%vs 85.8%,P<0.01)。简单相关分析显示:不论男女,AI(P<0.05)都随着年龄的增加而升高,随身高和血糖水平的增加而降低。男性饮酒者的 AI 显著高于不饮酒者(87.3%vs 85.2%,P=0.03)。多元逐步回归分析显示:身高、平均动脉压和空腹血糖是女性 AI 的独立影响因素。在男性,AI 还受年龄和饮酒的影响。结论在70岁以上老年人中,年龄、性别、身高、平均动脉压和血糖水平是 AI 的独立影响因素。
文摘目的观察厄贝沙坦对脉压(PP)≥60 mm Hg(1 mm Hg=0．133 kPa)高血压患者的动脉弹性功能、反射波及PP的影响。方法选取符合入选条件的原发性高血压患者30例,男13例、女17例,平均年龄为(65．2±8．5)岁(51～83岁),随机分成治疗组和对照组,分别给予厄贝沙坦(150 mg/d)和安慰剂治疗3个月。结果与治疗前相比,对照组治疗后中心和肱动脉收缩压、舒张压及PP轻度下降,但差异无显著性(P＞0．05)；而治疗组显著下降(P＜0．05),治疗组的降幅均显著高于对照组(P值分别＜0．05和0．01)。治疗后,治疗组的反射波增强压(AP)和增强指数(A1)明显下降(P＜0．01),颈-股动脉脉搏波传导速度(CF-PWV)显著变慢(P＜0．01),降幅显著高于对照组；大、小动脉弹性功能指数(Cl、C_2)值均显著增加(P值分别＜0．05和0．01),增幅显著高于对照组。分别以C_1和CF-PWV变化为应变量,收缩压、舒张压降幅为自变量行多元线形回归分析,决定系数(R2)为0．486及0．384(P＜0．05)。结论厄贝沙坦可明显改善PP≥60mm Hg高血压患者的大、小动脉弹性,减弱外周波反射,缩小PP。
文摘目的观察原发性高血压(essential hypertension,EH)患者桡动脉反射波增强指数(radialartery augmenta-tion index of reflected wave,rAI)的变化,探讨血压与rAI之间的关系。方法分别测定120例血压正常的健康者和120例EH患者(按照血压的不同分为EH1级组、EH2级组、EH3级组,每组各40例)的rAI值。结果 rAI值:对照组<EH1级组<EH2级组<EH3级组,4组间差异均有统计学意义(P<0.05)。结论 rAI随血压的增高而升高,检测rAI有助于早期发现高血压动脉弹性功能的变化,是反映高血压动脉僵硬度的可靠指标。
