國家衛生研究院 NHRI:Item 3990099045/9362
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    題名: Central aortic reservoir-wave analysis predicted 20-year all-cause and cardiovascular mortalities independently of wave reflection and arterial stiffness: A community-based study
    作者: Cheng, HM;Chuang, SY;Sung, SH;Spurgeon, HA;Ting, CT;Najjar, SS;Lakatta, EG;Yin, FCP;Chou, P;Chen, CH
    貢獻者: Division of Health Services and Preventive Medicine
    摘要: Central aortic pressure waveforms contain incremental prognostic value in addition to traditional cardiovascular risk factors. Recently, pressure wave propagation theory and its derived parameters, pulse wave velocity (PWV) and backward wave amplitudes (Pb) has been demonstrated to provide incremental value in addition to currently accepted biomarkers in various study population. Subsequently, parameters calculated based on the reservoir-wave concept, combining elements of wave transmission and Windkessel models of arterial pressure generation, has been shown to predict clinical outcomes in elderly patients with hypertension. However, the comparative utility of the above parameters in prediction of cardiovascular events is unknown. Carotid blood pressure waveforms were measured in a community-based survey of 1172 patients (47% women, mean age 52±13 years old, range 30–79 years), which were decomposed into their forward wave amplitudes (Pf), backward wave amplitudes (Pb), and a reflection index (RI, = [Pb/(Pf+Pb)]). Reservoir-wave analysis was performed and indices of arterial function, including the systolic and diastolic rate constants, were derived. During a median follow-up of 19.8 years, 315 (26.9%) deaths occurred, including 84 (7.2%) cardiovascular origins. In multivariate analysis accounting for age, sex, body mass index, systolic blood pressure, fasting glucose, HDL cholesterol, LDL cholesterol, smoking, PWV and Pb, reservoir-wave parameters: systolic rate constant (Wald X2 =14.60, p<0.0001), diastolic rate constant (Wald X2 =20.25, p<0.0001), and reservoir pressure integral (Wald X2 =17.26, p<0.0001), could independently predict cardiovascular mortality. Moreover, to predict cardiovascular and total mortality, the addition of diastolic rate constant to the above multivariate model resulted in significant net incremental improvement in the risk assessment (net reclassification index = 0.14; p=0.01 and 0.04, p=0.003, respectively). In conclusion, reservoir-wave approach could predict long term outcomes in general population independently of arterial propagation parameters.
    日期: 2015-08
    關聯: European Heart Journal. 2015 Aug;36(Suppl.1):979.
    Link to: http://dx.doi.org/10.1093/eurheartj/ehv401
    JIF/Ranking 2023: http://gateway.webofknowledge.com/gateway/Gateway.cgi?GWVersion=2&SrcAuth=NHRI&SrcApp=NHRI_IR&KeyISSN=0195-668X&DestApp=IC2JCR
    Cited Times(WOS): https://www.webofscience.com/wos/woscc/full-record/WOS:000361205106483
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