LEFT ATRIAL SIZE AND THE RISK OF STROKE AND DEATH - THE FRAMINGHAM HEART-STUDY
LEFT ATRIAL SIZE AND THE RISK OF STROKE AND DEATH - THE FRAMINGHAM HEART-STUDY
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DOI：
10.1161/01.cir.92.4.835
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发表时间：
1995-08-15
期刊：
影响因子：
37.8
通讯作者：
LEVY, D
中科院分区：
文献类型：
--
作者：
BENJAMIN, EJ;DAGOSTINO, RB;LEVY, D
背景：医学文献中关于左心房扩大与卒中风险相关性的报道相互矛盾。LA大小的关系，中风和死亡的风险在一般population.Methods和结果的主题50岁及以上的心脏研究的心脏Fractionary进行了研究，以评估超声心动图LA大小和中风和死亡的风险之间的关系。在8年的随访中，1371名男性中有64名（4.7%）和1728名女性中有73名（4.2%）发生卒中，296名男性（21.6%）和271名女性（15.7%）死亡。性别特异性考克斯比例风险模型校正了年龄、高血压、糖尿病、房颤、吸烟、ECG左心室（LV）肥大和充血性心力衰竭或心肌梗死。多变量校正后，左心房每增加10毫米，男性中风的相对危险度为2.4（95% CI，1.6 - 3.7），女性为1.4（95% CI，0.9至2.1）;男性的相对死亡风险为1.3（95% CI，1.0至1.5），女性为1.4（95% CI，1.1至1.7）。调整心电图左室质量/高度衰减LA大小中风和death.Conclusions的关系后，多变量调整，LA扩大仍然是一个显着的预测中风的男性和死亡的性别。左心房扩大与卒中和死亡的关系似乎部分由左心室质量介导。
Background The medical literature contains conflicting reports on the association of left atrial (LA) enlargement with risk of stroke. The relation of LA size to risk of stroke and death in the general population remains largely unexplored.Methods and Results Subjects 50 years of age and older from the Framingham Heart Study were studied to assess the relations between echocardiographic LA size and risk of stroke and death. During 8 years of follow-up, 64 of 1371 (4.7%) men and 73 of 1728 (4.2%) women sustained a stroke, and 296 (21.6%) men and 271 (15.7%) women died. Sex-specific Cox proportional-hazards models were adjusted for age, hypertension, diabetes, atrial fibrillation, smoking, ECG left ventricular (LV) hypertrophy, and congestive heart failure or myocardial infarction. After multivariable adjustment, for every 10-mm increase in LA size, the relative risk of stroke was 2.4 in men (95% CI, 1.6 to 3.7) and 1.4 in women (95% CI, 0.9 to 2.1); the relative risk of death was 1.3 in men (95% CI, 1.0 to 1.5) and 1.4 in women (95% CI, 1.1 to 1.7). Adjusting for ECG LV mass/height attenuated the relation of LA size to stroke and death.Conclusions After multivariable adjustment, LA enlargement remained a significant predictor of stroke in men and death in both sexes. The relation of LA enlargement to stroke and death appears to be partially mediated by LV mass.