大动脉僵硬研究进展ppt课件.ppt

Update on Arterial Stiffness大动脉僵硬研究进展;Definition of Blood Pressure; PULSE WAVE;;The pulsatile component, PP;arterial stiffness PP;PWV ALL-CAUSE MORTALITYIN 1980 HYPERTENSIVES;PWV PROBABILITIES OF OVERALL AND EVENT-FREE SURVIVAL IN HEMODIALYSIS PATIENTS;2.年轻人在生理条件下脉搏波速度（PWV）较慢，反射波落在升主动脉压力波的舒张期（上图）。由于衰老动脉硬度不断增加，PWV加快，反射波提前产生，落在中心动脉压力波的收缩期而而主动脉舒张期压力下降（下图） 。;Determinants of Arterial Stiffness;Amplitude of Earlier Wave Reflections mainly based on the geometry, number, structure, and function of smaller muscular arteries and arterioles which serve as major reflection sites;动脉硬度与心血管危险 ;0;Evaluation of arterial stiffness;Pulse Wave VelocityPulse Wave Analysis;Arterial pulse and pulse wave velocity(PWV)PWV=Distance/Pulse transit time;Augmentation Index(AI)=Δp/ppAI is a time domain estimater of the contribution of the reflections relative to the pulse pressure;Applanation tonometry Pressure Recording; Pulse wave from SphygmoCor Central aortic pressure waveforms can be calculated from the radial artery pressure waveform using a generalized transfer function ;Other Surrogate Measures of stiffness;Other methods for measuring arterial stiffness;Question;Some key questions to ask before using biomarkers;Reduction in LV mass with therapy in 2 years;Effects of physiological phenomena on the arterial stiffness;;;Nichols WW, O’Rourke MF. McDonald’s Blood Flow in Arteries. 5th ed. London; Arnold Hodder 2005;PWV with age Reproduced from Avalio,et al.;Change in contour and amplitude of pressure waves recorded in the radial artery and carotid in normal subjects between the first and eighth decade of life;Disorders with great effects on arterial stiffness;Pressure/diameter relationships show schematically for an elastic artery of a normal subject(left) and an age-matched patient with hypertension(right);ARTERIAL STIFFNESS BODY MASS INDEXPWV is related to BMI ;PWV is related to glucose intolerance and diabetes;13;ARTERIAL STIFFNESS THERAPY;Therapy for Arterial Stiffness