BACKGROUND Lower pulmonary artery acceleration time (PAcT) is correlated with higher pulmonary artery pressure. The aim of this study was to test the hypothesis that PAcT measured in young adulthood would be associated with future cardiovascular outcomes. METHODS In the Coronary Artery Risk Development in Young Adults year 5 examination (1990-1991), PAcT was measured as the time interval from onset to peak flow velocity at the pulmonary valve annulus on Doppler echocardiography. The primary outcome was a composite of fatal or nonfatal cardiovascular disease events: myocardial infarction, non-myocardial infarction acute coronary syndrome, coronary revascularization, congestive heart failure, stroke, transient ischemic attack, carotid artery disease, and peripheral arterial disease. RESULTS PAcT was obtained in 4,171 participants (mean age, 30 ± 4 years, 55% women, 51% white). PAcT groups obtained using linear spline methodology were as follows: group I, PAcT ≥ 196 msec (n = 122); group II, PAcT < 196 and ≥115 msec (n = 3,195); and group III, PAcT < 115 msec (n = 854). During follow-up (median, 24.9 years), the primary outcome occurred in 216 participants (5.2%); 66 of 854 (7.7%) of those with PAcT < 115 msec, 149 of 3,195 (4.7%) of those with intermediate PAcT level, and one of 122 (0.8%) of those with PAcT ≥ 196 msec. In a fully adjusted model, the lowest and intermediate PAcT groups had hazard ratios of 8.3 (95% CI, 1.1-62.1; P = .04) and 6.8 (95% CI, 0.9-50.5; P = .06), respectively, in comparison with the highest PAcT group. CONCLUSIONS PAcT is useful for better identifying young adults at higher risk for cardiovascular events, who may benefit from a strict control of modifiable cardiovascular risk factors.

中文翻译：

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青年期的肺动脉加速时间和晚年的心血管结果：青年期冠状动脉风险发展研究。

背景 较低的肺动脉加速时间（PAcT）与较高的肺动脉压力相关。本研究的目的是检验成年早期测量的 PAcT 与未来心血管结局相关的假设。方法 在年轻人冠状动脉风险发展第 5 年检查（1990-1991）中，PAcT 被测量为多普勒超声心动图上肺动脉瓣环处从发病到峰值流速的时间间隔。主要结局是致命或非致命心血管疾病事件的复合：心肌梗死、非心肌梗死急性冠状动脉综合征、冠状动脉血运重建、充血性心力衰竭、中风、短暂性脑缺血发作、颈动脉疾病和外周动脉疾病。结果 4,171 名参与者获得了 PAcT（平均年龄 30 ± 4 岁，55% 为女性，51% 为白人）。使用线性样条方法获得的 PAcT 组如下： I 组，PAcT ≥ 196 毫秒（n = 122）；II 组，PAcT < 196 且≥115 毫秒 (n = 3,195)；III 组，PAcT < 115 毫秒 (n = 854)。在随访期间（中位时间为 24.9 年），216 名参与者（5.2%）出现了主要结局；854 名 PAcT < 115 毫秒的患者中有 66 名 (7.7%)，3,195 名中等 PAcT 水平的患者中有 149 名 (4.7%)，122 名 PAcT ≥ 196 毫秒的患者中有 1 名 (0.8%)。在完全调整的模型中，最低和中间 PAcT 组的风险比分别为 8.3 (95% CI, 1.1-62.1; P = .04) 和 6.8 (95% CI, 0.9-50.5; P = .06)，与最高 PAcT 组相比。结论 PAcT 对于更好地识别心血管事件风险较高的年轻人很有用，他们可能受益于严格控制可改变的心血管危险因素。