南宫授课金波PWV.ppt

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 on Survival in End-Stage Renal Disease Adapt from Circulation. 1999;99:2434-2439. 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. Impact of Aortic Stiffness Attenuation on Survival in ESRD 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 Impact of Aortic Stiffness Attenuation on Survival in ESRD PWV is strong surrogate marker of cardiovascular events or total death. A Systematic Review and Meta-Analysis Vlachopoulos C et al. JACC 2010;55:1318-1327 Question 如何对动脉僵硬度增高进行干预？ pwv treatment 长期药物治疗(≥28d) 急性和短期药物治疗（28d） PWV ACEI 确诊的PAD患者40名：ABI0.9，并经血管超声证实 Ramipril(10 mg, once daily）VS. 安慰剂 疗程 ：24 w Ramipril Reduces Large-Artery Stiffness in PAD Ramipril Reduces Large-Artery Stiffness in PAD cell culture Ramipril Reduces Large-Artery Stiffness in PAD Ramipril Reduces Large-Artery Stiffness in PAD cell culture Fluvastatin and arterial stiffness 22 diatetic patients with ESRD on haemodialysis Received fluvastatin(20mg/day) 6 months Index: LDL-C, CRP, PWV Fluvastatin and arterial stiffness Fluvastatin and arterial stiffness The beneficial effect of fluvastatin may result from a statin-induced upregulation of endothelial nitric oxide synthase expression and/or activity. Improved Vascular Compliance by AGE-Crosslink Breaker Advanced Glycation End-Product Crosslink Breaker：ALT-711 共入选93人，随访