估算的脉搏波传导速度对新发心力衰竭的影响  

Association Between Estimated Pulse Wave Velocity and Risk of New Onset Heart Failure

作　　者：季春鹏[1] 汪国栋 黄喆[1] 朱辰蕊[1] 王娜[3] 刘妍[1] 王锦梅[4] 吴寿岭[1] JI Chunpeng;WANG Guodong;HUANG Zhe;ZHU Chenrui;WANG Na;LIU Yan;WANG Jinmei;WU Shouling(Department of Cardiology,Kailuan General Hospital,Tangshan 063000,China;Health Care Center,Kailuan Medical group,Tangshan 063000,China;Department of Cardiology,The Second Hospital of Qinhuangdao,Qinhuangdao 066600,China;Department of General Internal Medicine,Rehabilitation Hospital of Kailuan General Hospital,Tangshan 063000,China)

机构地区：[1]开滦总医院心内科,唐山063000 [2]开滦员工健康保障中心,唐山063000 [3]秦皇岛市第二医院心内科,秦皇岛066600 [4]开滦总医院康复医院普通内科,唐山063000

出　　处：《中国循环杂志》2023年第10期1030-1035,共6页Chinese Circulation Journal

基　　金：河北省卫生健康委员会青年科技课题(20210746)。

摘　　要：目的:探讨估算的脉搏波传导速度(ePWV)对新发心力衰竭的影响。方法:以参加2006年7月至2007年10月健康体检、无心力衰竭病史且资料完整的98269例开滦集团公司职工为观察队列,平均随访(13.85±1.40)年。将研究人群按e PWV四分位数分为四组:即Q1组(e PWV<12.54 m/s,n=24567)、Q2组(12.54 m/s≤ePWV<13.95 m/s,n=24567)、Q3组(13.95 m/s≤ePWV<15.44 m/s,n=24568)和Q4组(ePWV≥15.44m/s,n=24567),计算各组新发心力衰竭的发病密度。在校正传统心血管危险因素(包括性别、吸烟、饮酒、体育锻炼、文化程度、心血管家族史、心肌梗死病史、脑卒中病史、体重指数、总胆固醇、空腹血糖、血尿酸和C反应蛋白)后,采用多因素Cox回归模型分析e PWV对新发心力衰竭的影响。结果:随着ePWV四分位组的递增,新发心力衰竭的发病密度呈递增趋势,分别为0.48/千人年、1.21/千人年、2.45/千人年和5.42/千人年。在校正性别、吸烟、饮酒等传统心血管危险因素后,ePWV每增加1 m/s,心力衰竭的发生风险增加37%(HR=1.37,95%CI:1.34~1.39,P<0.01)。进一步分析显示,无论有无传统心血管危险因素、男性还是女性、青中年(<52岁)还是中老年(≥52岁),ePWV均与新发心力衰竭的发生存在显著关联(P均<0.01)。结论:ePWV是新发心力衰竭的独立危险因素。Objectives:To evaluate the association between estimated pulse wave velocity(ePWV)and risk of new onset heart failure.Methods:A total of 98269 employees free of heart failure,who participated in the health examination from July 2006 to October 2007,were selected as the observation cohort,the mean follow-up time was(13.85±1.40)years.The study population was divided into four groups according to the ePWV quartile:group Q1(ePWV<12.54 m/s,n=24567),group Q2(12.54 m/s≤ePWV<13.95 m/s,n=24567),group Q3(13.95 m/s≤ePWV<15.44 m/s,n=24568),and group Q4(ePWV≥15.44 m/s,n=24567).The incidence of new onset heart failure during follow-up was calculated in each group.After adjustment for the traditional cardiovascular risk factors(including gender,smoking,drinking,exercise,education level,family history of cardiovascular disease,history of myocardial infarction,history of stroke,body mass index,total cholesterol,fasting blood glucose,uric acid and C-reactive protein),multivariate cox regression models were used to evaluate the association between ePWV and risk of new onset heart failure.Results:The incidence of new onset heart failure showed an increasing trend with the increase of ePWV,which was 0.48/1000 person years,1.21/1000 person years,2.45/1000 person years and 5.42/1000 person years,respectively from group Q1 to Q4.After adjusting for the traditional cardiovascular risk factors,the risk of new onset heart failure increased by 37%(HR=1.37,95%CI:1.34-1.39,P<0.01)for each 1 m/s increase in ePWV.Further analysis showed that ePWV was significantly associated with the occurrence of new onset heart failure regardless of cardiovascular risk factors,male or female,young and middle-aged(<52 years)or middle-aged and elderly(≥52 years),all P<0.01.Conclusions:ePWV is an independent risk factor for new onset heart failure.

关 键 词：估算的脉搏波传导速度 臂踝脉搏波传导速度 心力衰竭 危险因素 

分 类 号：R54[医药卫生—心血管疾病]