南宫授课金波pwv 教材课程.ppt

动脉僵硬度和阻塞程度的临床应用;;评价大动脉僵硬度的方法;脉压;脉压;收缩压增高，舒张压降低，脉压明显增大;脉搏波速度(pulse wave velocity，PWV);脉搏波速度;通常，以颈总动脉搏动点作为脉搏波传导的起点;生理因素： 年龄：10岁以前大动脉僵硬度随年龄增长迅速下降，但随后的50年内则逐渐升高 性别：成年女性PWV略小于同龄男性，而在儿童和老年人群（即老年男性和绝经后女性）性别差异不明显。 基因：nitric oxide synthase 血压：无论是由于动脉性质改变，或是由于动脉内压力增大，均可致PWV增加 心率：长期心率较快可造成退行性改变加速;临床疾病： 高血压 糖尿病 冠心病 心功能不全 肾功能不全;The effects of aging on cf-PWV in males and females ;;;糖尿病;糖尿病相关蛋白尿;冠心病;;心功能不全;动脉僵硬度和慢性肾功能不全;Hypertension2005;45;1078-1082.;147 mm Hg;Hypertens Res 2005;28:125–131;Question;Arterial stiffness may predict coronary heart disease beyond classic risk factors;Impact of Aortic Stiffness on Survival in End-Stage Renal Disease;Conclusions 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 hemoglobin levels.;Impact of Aortic Stiffness Attenuation on Survival in ESRD;The risk ratio for the absence of PWV decrease was 2.59 for all-cause mortality and 2.35 for cardiovascular mortality.;Conclusions Arterial stiffness 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. In ESRF patients, the insensitivity of PWV to decreased BP is an independent predictor of mortality;PWV is strong surrogate marker of cardiovascular events or total death. A Systematic Review and Meta-Analysis;Question;pwv treatment;PWV ACEI;Ramipril Reduces Large-Artery Stiffness in PAD;Ramipril Reduces Large-Artery Stiffness in PAD;cell culture;Ramipril Reduces Large-Artery Stiffness in PAD;Fluvastatin and arterial stiffness;Fluvastatin and arterial stiffness;Fluvastatin and arterial stiffness;Improved Vascular Compliance by AGE-Crosslink Breaker;Improved Vascular Compliance by AGE-Crosslink Breaker;Improved Vascular Compliance by AGE-Crosslink Breaker;;*;Thanks !!!