Arterial stiffness: pathophysiology and clinical impact.

摘要: The ill effects of hypertension are usually attributed to a reduction in the caliber or number arterioles, resulting an increase total peripheral resistance (TPR). This definition does not take into account fact that BP is cyclic phenomenon with systolic and diastolic being limits these oscillations. appropriate term define arterial factor(s) opposing LV ejection aortic input impedance which depends on TPR, distensibility (D), wave reflections (WR). D defines capacitive properties stiffness, whose role dampen pressure flow oscillations transform pulsatile arteries steady tissues. Stiffness reciprocal value D. These parameters dependent, become stiffer at high pressure. In provides information about > artery as hollow structure, elastic incremental modulus (Einc) characterizes wall biomaterials, independently vessel geometry. As alternative, can be evaluated by measuring pulse velocity (PWV) increases stiffening arteries. Arterial left ventricular (LV) afterload alters coronary perfusion. With increased PWV, WR impacts aorta during systole, increasing pressures myocardial oxygen consumption, decreasing flow. stiffness altered primarily association collagen content alterations extracellular matrix (arteriosclerosis) classically observed aging hypertension. estimated changes PWV intensity independent predictors survival end stage renal disease (ESRD) general population. Improvement could obtained antihypertensive treatmen calcium-channel blocker ACE inhibitors. inhibitors AC reduced WR, it has been shown reversibility use inhbitors had favorable effect hypertensive patients advanced disease.