1、左室左室The Anglo-Cardiff Collaborative Trial(ACCT)Subjects 4,001 healthy normotensives aged 19-90years.AGE(Years)r=0.48*;y=0.123x+6.2720 30 40 50 60 70 80 90201612 8 4AGE(Years)NTHTy=0.0628x+5.728 y=0.123x+6.27201612 8 420 30 40 50 60 70 80 90*p 0.001*Asmar et al,Blood Pressure,1995HTNTn=224CAROTID-FEM
2、ORAL P.W.V.(m/s)CAROTID-FEMORAL P.W.V.(m/s)02468101214正常对照正常对照糖耐量低减糖耐量低减糖尿病糖尿病颈股颈股 PWV(m/s)*16糖尿病糖尿病(Adapted from Woolam et al.,1962)糖尿病相关蛋白尿(Adapted from Tanokuchi et al.,1962)0500100015002000PWV(cm/sec)NOR RISK CADMaleFemaleYamashina A et al.Hypertens Res 2002Yamashina A et al.Hypertens Res 2002 N
3、OR RISK CADadapted from Arnold et al.adapted from Arnold et al.Hypertension2005;45;1078-1082.Patients with the metabolic syndrome had a greater aortic PWV(9.72.0 versus 9.02.0m/s;P0.03).This difference held after controlling for the confounding effect of age and mean arterial pressure.147 mm HgHyper
4、tension2005;45;1078-1082.Hypertens Res 2005;28:125131Arterial stiffness may predict coronary heart Arterial stiffness may predict coronary heart disease beyond classic risk factorsdisease beyond classic risk factors1045 hypertensives without 1045 hypertensives without known clinical cardiovascular k
5、nown clinical cardiovascular diseasediseasemean follow-up was 5.7 yearsmean follow-up was 5.7 yearsAdapt from Hypertension.2002;39:10-15.Impact of Aortic Stiffness on Survival in Impact of Aortic Stiffness on Survival in End-Stage Renal DiseaseEnd-Stage Renal DiseaseAdapt from Circulation.1999;99:24
6、34-2439.Adapt from Circulation.1999;99:2434-2439.Conclusions n The role of arterial stiffening was independent of other factors known to affect the outcome of uremic patients,namely age,overall duration of ESRD,preexisting cardiovascular disease,degree of LV hypertrophy,BP,and serum albumin and hemo
7、globin levels.Impact of Aortic Stiffness on Survival in Impact of Aortic Stiffness on Survival in End-Stage Renal DiseaseEnd-Stage Renal DiseaseAdapt from Circulation.1999;99:2434-2439.Adapt from Circulation.1999;99:2434-2439.Impact of Aortic Stiffness Attenuation on Impact of Aortic Stiffness Atten
8、uation on Survival in ESRDSurvival in ESRDThe risk ratio for the absence of PWV decrease was 2.59 for all-cause mortality and 2.35 for cardiovascular mortality.Impact of Aortic Stiffness Attenuation on Impact of Aortic Stiffness Attenuation on Survival in ESRDSurvival in ESRDConclusions nArterial st
9、iffness is not only a risk factor contributing to the development of cardiovascular disease but also a marker of established,more advanced,less reversible arterial changes.nIn ESRF patients,the insensitivity of PWV to decreased BP is an independent predictor of mortalityImpact of Aortic Stiffness At
10、tenuation on Impact of Aortic Stiffness Attenuation on Survival in ESRDSurvival in ESRD长期药物治疗长期药物治疗(28d)急性和短期药物治疗（急性和短期药物治疗（28d）n确诊的PAD患者40名：ABI50岁n有动脉僵硬度增高的证据：PP 60 mm Hg,SBP140 mm Hg,large artery compliance 1.25 mL/mm Hgn维持原有降压药物不变至少4周（ACEI/ARB，-blocker，CCB，利尿剂）n排除标准：已知的心脑血管疾病、心脏瓣膜病、恶性高血压、1型或未控制稳定的2型糖尿病、严重肾脏疾病、活动性慢性肺部疾病、房颤、心功能不全等Improved Vascular Compliance by Improved Vascular Compliance by AGE-Crosslink BreakerAGE-Crosslink BreakerImproved Vascular Compliance by Improved Vascular Compliance by AGE-Crosslink BreakerAGE-Crosslink Breakerday28 day 56day28 day 5650
