Usefulness of Left Ventricular Mass and Geometry for Determining 10-Year Prediction of Cardiovascular Disease in Adults Aged >65 Years (from the Cardiovascular Health Study)
Usefulness of Left Ventricular Mass and Geometry for Determining 10-Year Prediction of Cardiovascular Disease in Adults Aged >65 Years (from the Cardiovascular Health Study)
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DOI：
10.1016/j.amjcard.2016.06.016
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发表时间：
2016-09-01
影响因子：
2.8
通讯作者：
Gardin, Julius M.
中科院分区：
文献类型：
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作者：
Desai, Chintan S.;Bartz, Traci M.;Gardin, Julius M.
左心室 (LV) 质量和几何形状与心血管疾病 (CVD) 的风险相关。我们试图确定 LV 质量和几何形状是否有助于心血管健康研究中 65 岁以上成年人的 CVD 风险预测。我们将 LV 质量与身体大小进行索引，表示为 LV 质量指数 (echo-LVMI)，并将 LV 几何形状定义为正常、向心重塑以及偏心或向心 LV 肥大。我们添加了回声 LVMI 和 LV 几何来分离包含传统风险因素的 10 年风险预测模型，并确定了突发冠心病 (CHD)、CVD（CHD、心力衰竭 [HF] 和中风）和单独 HF 的净重分类改善 (NRI)。对 2,577 名参与者（64% 为女性，15% 为黑人，平均年龄 72 岁）的 CHD 和 CVD 进行了超过 10 年的随访，1-SD 较高回声 LVMI 的调整后风险比分别为 1.25（95% CI 1.14 至 1.37）、1.24（1.15 至 1.33）和 1.51（1.40 至 1.37）。 1.62），分别。将 echo-LVMI 添加到 CHD 标准模型中，事件 NRI 为 -0.011（95% CI -0.037 至 0.028），非事件 NRI 为 0.034（95% CI 0.008 至 0.076）。将回声 LVMI 和 LV 几何结构添加到 CVD 标准模型中，事件 NRI 为 0.013（95% CI -0.0335 至 0.0311），非事件 NRI 为 0.043（95% CI 0.011 至 0.09）。添加回声 LVMI 进行心力衰竭风险预测后，非事件 NRI 也很显着（0.10，95% CI 0.057 至 0.16）。总之，在 65 岁以上的成年人中，echo-LVMI 改善了 CHD、CVD 和 HF 的风险预测，这主要是由于改进了非事件的重新分类。 (C) 2016 Elsevier Inc. 保留所有权利。
Left ventricular (LV) mass and geometry are associated with risk of cardiovascular disease (CVD). We sought to determine whether LV mass and geometry contribute to risk prediction for CVD in adults aged >= 65 years of the Cardiovascular Health Study. We indexed LV mass to body size, denoted as LV mass index (echo-LVMI), and we defined LV geometry as normal, concentric remodeling, and eccentric or concentric LV hypertrophy. We added echo-LVMI and LV geometry to separate 10-year risk prediction models containing traditional risk factors and determined the net reclassification improvement (NRI) for incident coronary heart disease (CHD), CVD (CHD, heart failure [HF], and stroke), and HF alone. Over 10 years of follow-up in 2,577 participants (64% women, 15% black, mean age 72 years) for CHD and CVD, the adjusted hazards ratios for a 1-SD higher echo-LVMI were 1.25 (95% CI 1.14 to 1.37), 1.24 (1.15 to 1.33), and 1.51 (1.40 to 1.62), respectively. Addition of echo-LVMI to the standard model for CHD resulted in an event NRI of -0.011 (95% CI -0.037 to 0.028) and nonevent NRI of 0.034 (95% CI 0.008 to 0.076). Addition of echo-LVMI and LV geometry to the standard model for CVD resulted in an event NRI of 0.013 (95% CI -0.0335 to 0.0311) and a nonevent NRI of 0.043 (95% CI 0.011 to 0.09). The nonevent NRI was also significant with addition of echo-LVMI for HF risk prediction (0.10, 95% CI 0.057 to 0.16). In conclusion, in adults aged >= 65 years, echo-LVMI improved risk prediction for CHD, CVD, and HF, driven primarily by improved reclassification of nonevents. (C) 2016 Elsevier Inc. All rights reserved.