[1]杨子玄?刘圣?亢玉?张庆.新指标评估结缔组织病患者动脉僵硬度及其对左室舒张功能的影响[J].心血管病学进展,2022,(5):475-480.[doi:10.16806/j.cnki.issn.1004-3934.2022.05.021]
　YANG Zixuan,LIU Sheng,KANG Yu,et al.Arterial Stiffness Assessed by New Indices in Patients with Connective Tissue Disease and Their Association with Left Ventricular Diastolic Function[J].Advances in Cardiovascular Diseases,2022,(5):475-480.[doi:10.16806/j.cnki.issn.1004-3934.2022.05.021]
点击复制

新指标评估结缔组织病患者动脉僵硬度及其对左室舒张功能的影响()
分享到：

《心血管病学进展》[ISSN:51-1187/R/CN:1004-3934]

卷:
期数:
2022年5期
页码:
475-480
栏目:
出版日期:
2022-05-25

文章信息/Info

Title:
Arterial Stiffness Assessed by New Indices in Patients with Connective Tissue Disease and Their Association with Left Ventricular Diastolic Function
作者:
杨子玄1?刘圣2?亢玉1?张庆1
(1.四川大学华西医院心内科,四川 成都 610041;2. 重庆市垫江县人民医院心内科,重庆 408399)
Author(s):
YANG Zixuan1; LIU Sheng2; KANG Yu1; ZHANG Qing1
Department of Cardiology,West China Hospital of Sichuan University,Chengdu 610041,Sichuan,China; 2. Department of Cardiology,Dianjiang People’s Hospital of Chongqing,Chongqing 408399,China)?/html>
关键词:
结缔组织病; 动脉僵硬度; 动脉波速指数; 动脉压力容积指数; 左室舒张功能障碍
Keywords:
Connective tissue disease; Arterial stiffness; Arterial velocity pulse index; Arterial pressure volume index; Left ventricular diastolic dysfunction
DOI:
10.16806/j.cnki.issn.1004-3934.2022.05.021
摘要:
目的 利用新型动脉僵硬度指标动脉波速指数（AVI）和动脉压力容积指数（API），对结缔组织病（CTD）患者的中心动脉与外周动脉僵硬度进行评估，并探索其与左室舒张功能障碍（LVDD）的关系。 方法 自2019年4 ～7月连续纳入住院CTD患者作为病例组（n=150），按照3∶1同期纳入性别和年龄匹配的非CTD患者为对照组（n=50），采用t检验比较两组患者的临床特征、AVI和API的差异。在CTD病例组内，采用多元线性回归分析AVI和API的影响因素，采用二元逻辑回归探究AVI和API与LVDD的关联。 结果 病例组收缩压 [(120±18) mm Hg vs (113±16) mm Hg，P=0.009]，AVI（17±6 vs 15±4，P=0.005），API（25±6 vs 23±4，P=0.007），以及LVDD（＋）占比（24.7% vs 8.0%，P=0.014）均显著高于对照组。在病例组内，AVI和API均与年龄和收缩压呈独立正相关（P<0.05），此外，AVI还与C反应蛋白独立相关（标准化β=0.131，P=0.042）。经矫正年龄、体重指数、血压和CTD病程，AVI与LVDD（＋）独立相关（OR=1.129，P=0.015），而API与之无相关性。 结论 CTD患者 的新型动脉僵硬度指标AVI和API高于非CTD患者，且C反应蛋白增高、AVI升高以及合并LVDD之间具有相关性。CTD如何导致AVI和API升高以及其在心血管危险分层中的意义仍需进一步研究。
Abstract:
Objective To assess the stiffness of central and peripheral arteries in patients with connective tissue disease(CTD) by using the new indices, arterial velocity pulse index(AVI) and arterial pressure volume index(API),and to explore the association between arterial stiffness and left ventricular diastolic dysfunction(LVDD). Methods From April to July 2019,hospitalized CTD patients were continuously included as the case group(n=150),and non-CTD patients matched by gender and age were included as the control group(n=50) at the same time according to 3∶1. The differences of clinical characteristics,AVI and API between the two groups were compared by t-test. In the case group,multiple linear regression was used to explore the factors associated with AVI and API,and binary logistic regression was used to investigate the association between AVI,API and LVDD. Results The CTD group had higher systolic blood pressure [(120±18) mm Hg vs (113±16) mm Hg,P=0.009],AVI (17±6 vs 15±4，P=0.005), API(25±6 vs 23±4，P=0.007),and proportion of LVDD(+)(24.7% vs 8.0%，P=0.014) than the control group. Among CTD patients,both AVI and API were positively related to age and systolic blood pressure(P<0.05),but AVI was also independently correlated with C-reactive protein(standardized β=0.134, P=0.018). After adjusting for age, body mass index,blood pressure and CTD course ,AVI was independently correlated with LVDD(+) (OR=1.129, P =0.015),but API was not correlated with it. Conclusion The new arterial stiffness indexes(AVI and API) in CTD patients were higher than those in non-CTD patients,and there was a correlation between the increase of CRP,AVI and LVDD. How CTD leads to the increase of AVI and API and its significance in cardiovascular risk stratification still need to be further studied.

参考文献/References:

[1].Baena-Diez JM,Garcia-Gil M,Comas-Cufi M,et al. Association between chronic immune-mediated inflammatory diseases and cardiovascular risk[J]. Heart,2018,104(2):119-126.
[2].Garen T,Lerang K,Hoffmann-Vold AM,et al. Mortality and causes of death across the systemic connective tissue diseases and the primary systemic vasculitides[J]. Rheumatology(Oxford),2019,58(2):313-320.
[3].Agca R,Heslinga SC,Rollefstad S,et al. EULAR recommendations for cardiovascular disease risk management in patients with rheumatoid arthritis and other forms of inflammatory joint disorders:2015/2016 update[J]. Ann Rheum Dis,2017,76(1):17-28.
[4].Suciu CF,Prete M,Ruscitti P,et al. Oxidized low density lipoproteins:the bridge between atherosclerosis and autoimmunity. Possible implications in accelerated atherosclerosis and for immune intervention in autoimmune rheumatic disorders[J]. Autoimmun Rev,2018,17(4):366-375.
[5].Arida A,Protogerou AD,Kitas GD,et al. Systemic inflammatory response and atherosclerosis:the paradigm of chronic inflammatory rheumatic diseases[J]. Int J Mol Sci,2018,19(7):1890.
[6].Della Corte V,Tuttolomondo A,Pecoraro R,et al. Inflammation,endothelial dysfunction and arterial stiffness as therapeutic targets in cardiovascular medicine[J]. Curr Pharm Des,2016,22(30):4658-4668.
[7].Hedar AM,Stradner MH,Roessler A,et al. Autoimmune rheumatic diseases and vascular function:the concept of autoimmune atherosclerosis[J]. J Clin Med,2021,10(19):4427.
[8].Bruno RM,Bianchini E,Faita F,et al. Intima media thickness,pulse wave velocity,and flow mediated dilation[J]. Cardiovasc Ultrasound,2014,12:34.
[9].Watanabe J,Iwazu Y,Kotani K. Pulse wave velocity,carotid intima media thickness and flow-mediated dilation in Takayasu arteritis:a systematic review[J]. Arch Med Sci Atheroscler Dis,2021,6:e79-e84.
[10].Zhang Y,Yin P,Xu Z,et al. Non-invasive assessment of early atherosclerosis based on new arterial stiffness indices measured with an upper-arm oscillometric device[J]. Tohoku J Exp Med,2017,241(4):263-270.
[11].Komine H,Asai Y,Yokoi T,et al. Non-invasive assessment of arterial stiffness using oscillometric blood pressure measurement[J]. Biomed Eng Online,2012,11:6.
[12].Okamoto M,Nakamura F,Musha T,et al. Association between novel arterial stiffness indices and risk factors of cardiovascular disease[J]. BMC Cardiovasc Disord,2016,16(1):211.
[13].Komatsu S,Tomiyama H,Kimura K,et al. Comparison of the clinical significance of single cuff-based arterial stiffness parameters with that of the commonly used parameters[J]. J Cardiol,2017,69(4):678-683.
[14].Nagueh SF,Smiseth OA,Appleton CP,et al. Recommendations for the evaluation of left ventricular diastolic function by echocardiography:an update from the American Society of Echocardiography and the European Association of Cardiovascular Imaging[J]. J Am Soc Echocardiogr,2016,29(4):277-314.
[15].Wan J,Liu S,Yang Y,et al. Roles of arterial pressure volume index and arterial velocity pulse index trajectories in risk prediction in hypertensive patients with heart failure with preserved ejection fraction[J]. Clin Exp Hypertens,2020,42(5):469-478.
[16].Wu S,Jin C,Li S,et al. Aging,arterial stiffness,and blood pressure association in Chinese adults[J]. Hypertension,2019,73(4):893-899.
[17].Dregan A. Arterial stiffness association with chronic inflammatory disorders in the UK Biobank study[J]. Heart,2018,104(15):1257-1262.
[18].Townsend RR,Wilkinson IB,Schiffrin EL,et al. Recommendations for improving and standardizing vascular research on arterial stiffness:a scientific statement from the American Heart Association[J]. Hypertension,2015,66(3):698-722.
[19].Berger M,Fesler P,Roubille C. Arterial stiffness,the hidden face of cardiovascular risk in autoimmune and chronic inflammatory rheumatic diseases[J]. Autoimmun Rev,2021,20(9):102891.
[20].Mercurio V,Lobasso A,Barbieri L,et al. Inflammatory,serological and vascular determinants of cardiovascular disease in systemic lupus erythematosus patients[J]. Int J Mol Sci,2019,20(9):2154.
[21].Provan SA,Angel K,Semb AG,et al. Early prediction of increased arterial stiffness in patients with chronic inflammation:a 15-year followup study of 108 patients with rheumatoid arthritis[J]. J Rheumatol,2011,38(4):606-612.
[22].Mozos I,Malainer C,Horbanczuk J,et al. Inflammatory markers for arterial stiffness in cardiovascular diseases[J]. Front Immunol,2017,8:1058.
[23].Diederichsen LP,Simonsen JA,Diederichsen AC,et al. Cardiac abnormalities in adult patients with polymyositis or dermatomyositis as assessed by noninvasive modalities[J]. Arthritis Care Res(Hoboken),2016,68(7):1012-1020.
[24].Leone P,Cicco S,Prete M,et al. Early echocardiographic detection of left ventricular diastolic dysfunction in patients with systemic lupus erythematosus asymptomatic for cardiovascular disease[J]. Clin Exp Med,2020,20(1):11-19.
[25].Kumar KVSH,Renjith AS,Marwaha V,et al. Prevalence of left ventricular dysfunction in rheumatoid arthritis[J]. J Family Med Prim Care,2017,6(3):622-626.

相似文献/References:

[1]周力,李虹伟.结缔组织病并发冠状动脉性心脏病的危险因素[J].心血管病学进展,2015,(5):567.[doi:10.3969/j.issn.1004-3934.2015.05.011]
　ZHOU Li,LI Hongwei.Risk Factors for Coronary Heart Disease in Connective Tissue Diseases[J].Advances in Cardiovascular Diseases,2015,(5):567.[doi:10.3969/j.issn.1004-3934.2015.05.011]
[2]徐学萍 汪汉 蔡琳.结缔组织病相关心脏瓣膜病[J].心血管病学进展,2019,(9):1267.[doi:10.16806/j.cnki.issn.1004-3934.2019.09.021]
　XU Xueping,WANG Han,CAI Lin.Connective Tissue Disease-associated Valvular Heart Disease[J].Advances in Cardiovascular Diseases,2019,(5):1267.[doi:10.16806/j.cnki.issn.1004-3934.2019.09.021]
[3]刘圣 周骏腾 张庆.动脉僵硬度无创评估及其在心力衰竭中的应用[J].心血管病学进展,2020,(11):1160.[doi:10.16806/j.cnki.issn.1004-3934.2020.11.000]
　LIU Sheng,ZHOU Junteng,ZHANG Qing.Noninvasive Assessment of A rterial Stiffness and Application in Heart Failure[J].Advances in Cardiovascular Diseases,2020,(5):1160.[doi:10.16806/j.cnki.issn.1004-3934.2020.11.000]
[4]杨晓倩 张艺文 秦 莉 汪 汉.基于CiteSpace的结缔组织病相关肺动脉高压的文献分析[J].心血管病学进展,2021,(12):1129.[doi:10.16806/j.cnki.issn.1004-3934.2021.12.018]
　YANG Xiaoqian,ZHANG Yiwen,QIN Li,et al.Literature Analysis of Connective Tissue Disease-Related Pulmonary ArteriaHypertension Based on CiteSpace[J].Advances in Cardiovascular Diseases,2021,(5):1129.[doi:10.16806/j.cnki.issn.1004-3934.2021.12.018]
[5]唐建辉 陈锋 汪汉.血清尿酸与结缔组织病[J].心血管病学进展,2022,(8):743.[doi:10.16806/j.cnki.issn.1004-3934.2022.08.019]
　TANG Jianhui,CHEN Feng,WANG Han?/html>.Serum Uric Acid and Connective Tissue Diseases[J].Advances in Cardiovascular Diseases,2022,(5):743.[doi:10.16806/j.cnki.issn.1004-3934.2022.08.019]

更新日期/Last Update: 2022-06-30