肱动脉血流介导的血管扩张作为明显冠状动脉疾病指示因素的性别差异

作     者：Patel A.R. Kuvin J.T. Sliney K.A. 任付先 

作者机构：Division of Cardiology Department of Medicine Tufts-New England Medical Center BostonMA United States Dr. 

出 版 物：《世界核心医学期刊文摘(心脏病学分册)》 (Digest of the World Core Medical Journals(Cardiology))

年 卷 期：2006年第3期

页      面：37-37页

学科分类：1002[医学-临床医学] 100201[医学-内科学(含：心血管病、血液病、呼吸系病、消化系病、内分泌与代谢病、肾病、风湿病、传染病)] 10[医学] 

主　　题：肱动脉 血管扩张 冠状动脉疾病 血流介导 性别差异 差异(心理学) 

摘      要：Ultrasound of the brachial artery is widely used to assess endothelial function, but whether brachial artery flow-mediated vasodilation(FMD) differs between women and men who have coronary artery disease(CAD) has not been examined. To investigate gender-based differences in brachial artery FMD as an indicator of significant CAD, FMD was measured in women and men outpatients who had CAD(coronary stenosis 50% , n=64) and those who did not have significant CAD(n=145). FMD in women who had CAD(n=33, 9.1± 0.8% ) was higher than that in similarly aged men who had CAD(n=31, 6.4± 0.5% ; p=0.008). The FMD cutpoint that maximized sensitivity with least effect on specificity for screening CAD was 15% (91% sensitivity, 25% specificity) in women but 10% (90% sensitivity, 43% specificity) in men. If the cutpoint as defined in men were used to evaluate women, brachial artery ultrasound would fail to diagnose 42% of women who do not have significant CAD; thus, a higher FMD cutpoint is required to optimize the sensitivity of FMD for identifying women who have significant CAD compared with similarly aged men. In studies using FMD to evaluate cardiovascular risk, different standards should be applied for women and men.