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腕間血圧差のある末梢動脈疾患患者における機能的および心血管パラメータ
Functional and Cardiovascular Parameters in Peripheral Artery Disease Patients with Interarm Blood Pressure Difference.
PMID: 32634564 DOI: 10.1016/j.avsg.2020.06.055.
抄録
目的:
末梢動脈疾患(PAD)患者の機能パラメータおよび心血管パラメータにおける両腕間血圧差(IAD)の影響を解析した。
OBJECTIVE: To analyze the impact of inter-arm blood pressure difference (IAD) in functional and cardiovascular parameters in patients with peripheral artery disease (PAD).
患者および方法:
この横断的研究ではPAD患者98人が募集された。収縮期血圧および/または拡張期血圧が10mmHg以上の患者をIADと分類し、残りの患者をPAD対照群とした。機能パラメータには、6分間の歩行テスト、短い身体パフォーマンス・バッテリー、歩行障害質問票(WIQ)、および履歴から算出された歩行推定制限(WELCH)が含まれた。全身の心血管系パラメータは動脈硬化と心拍変動であった。両腕で評価された局所心血管系パラメータは上腕血圧と流量介在性拡張であった。
PATIENTS AND METHODS: Ninety-eight patients with PAD were recruited in this cross-sectional study. Patients with differences between the right and left arms of systolic and/or diastolic blood pressure ≥10 mmHg were classified as IAD, while the remaining patients were classified as PAD controls. Functional parameters included were the six-minute walk test, short physical performance battery, walking impairment questionnaire (WIQ), and the walking estimated-limitation calculated by history (WELCH). Systemic cardiovascular parameters included were arterial stiffness and heart rate variability. Local cardiovascular parameters assessed in both arms were brachial blood pressure and flow-mediated dilation.
結果:
IAD患者はControl患者と比較して収縮期血圧と脈圧が高かった(p<0.01)。IAD患者はPADコントロール患者と比較して、short physical performance battery(P=0.012)、WIQ distance(P=0.003)、WIQ speed(P=0.008)、WIQ staircle climbing(P=0.034)、WELCH(P=0.026)のスコアが低かった。
RESULTS: Patients with IAD presented higher systolic BP and pulse pressure compared to Control patients (p<0.01). The cfPWV tended to be higher and flow-mediated dilation tended to be lower in PAD patients with IAD compared to Controls (P<0.09).Patients with IAD presented lower scores in short physical performance battery (P=0.012), WIQ distance (P=0.003), WIQ speed (P=0.008), WIQ stair climbing (P=0.034), and WELCH (P=0.026) when compared to PAD control patients.
結論:
PAD患者では,IADはIADなしのPAD患者と比較して,身体機能の低下および心血管パラメータの障害と関連している。
CONCLUSION: In PAD patients, IAD is associated with lower physical function and impairments in cardiovascular parameters compared to PAD patients without IAD.
Copyright © 2020. Published by Elsevier Inc.