Christina Antza, Victoria Potoupni, Evangelos Akrivos, Stella Stabouli, Vasilios Kotsis
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引用次数: 0
摘要
背景:脉搏波速度(PWV)仍然是评估早期血管老化(EVA)(由动脉僵化定义)的黄金标准方法。然而,该方法成本高、耗时长,而且需要有资质的医务人员,这表明确定 EVA 评估替代方法的重要性:为了简化评估患者 EVA 的过程,我们最近开发了早期血管老化非卧床评分(EVAAs),这是一种预测 EVA 风险的简单工具。本研究的目的是在独立人群中对 EVAAs 进行外部验证:本研究纳入了 879 名(46.3% 为男性)转诊至高血压 ESH 高级研究中心的患者。平均年龄为 46.43 ± 22.87 岁。EVA 通过两种不同的方式进行评估。第一种评估包括 c-f 脉搏波速度值,第二种评估包括不直接测量颈动脉-股动脉脉搏波速度的 EVA:零假设是,根据 EVAA 预测 EVA 与根据 c-f 脉搏波速度计算预测 EVA 在统计学上没有显著差异。平均平方误差(MSE)用于评估零假设,结果发现为 0.40。结果显示,EVAAs 显示出 EVA 的概率,灵敏度为 0.98,特异度为 0.75。EVAA的阳性预测值为95%,阴性预测值为92%:我们的研究表明,EVAAs 与颈动脉-股骨脉搏波速度一样可靠,可用于识别 EVA 患者。因此,我们希望 EVAAs 将成为临床实践中的有用工具。
Assessment of Early Vascular Aging Ambulatory Score (EVAAs): A Large Population-based External Validation Study.
Background: Pulse Wave Velocity (PWV) remains the gold-standard method to assess Early Vascular Aging (EVA) defined by arterial stiffness. However, its high cost, time-consuming process, and need for qualified medical staff shows the importance of identifying alternative methods for the EVA evaluation.
Objective: In order to simplify the process of assessing patient's EVA, we recently developed the Early Vascular Aging Ambulatory score (EVAAs), a simple tool to predict the risk of EVA. The aim of the present study was the external validation of EVAAs in an independent population.
Methods: Eight hundred seventy-nine (46.3% men) patients who were referred to our Hypertension ESH Excellence Center were included in this study. The mean age was 46.43 ± 22.87 years. EVA was evaluated in two different ways. The first assessment included c-f PWV values, whereas the second one included EVAAs without the direct measurement of carotid-femoral PWV.
Results: The null hypothesis was that the prediction of EVA based on EVAAs does not present any statistically significant difference compared to the prediction based on the calculation from c-f PWV. Mean squared error (MSE) was used for the assessment of the null hypothesis, which was found to be 0.40. The results revealed that the EVAAs shows the probability of EVA with 0.98 sensitivity and 0.75 specificity. The EVAAs present 95% positive predictive value and 92% negative predictive value.
Conclusion: Our study revealed that EVAAs could be as reliable as the carotid-femoral PWV to identify patients with EVA. Hence, we hope that EVAAs will be a useful tool in clinical practice.
期刊介绍:
Current Vascular Pharmacology publishes clinical and research-based reviews/mini-reviews, original research articles, letters, debates, drug clinical trial studies and guest edited issues to update all those concerned with the treatment of vascular disease, bridging the gap between clinical practice and ongoing research.
Vascular disease is the commonest cause of death in Westernized countries and its incidence is on the increase in developing countries. It follows that considerable research is directed at establishing effective treatment for acute vascular events. Long-term treatment has also received considerable attention (e.g. for symptomatic relief). Furthermore, effective prevention, whether primary or secondary, is backed by the findings of several landmark trials. Vascular disease is a complex field with primary care physicians and nurse practitioners as well as several specialties involved. The latter include cardiology, vascular and cardio thoracic surgery, general medicine, radiology, clinical pharmacology and neurology (stroke units).