Modelling relations between blood pressure, cardiovascular phenotype, and clinical factors using large scale imaging data.
Modelling relations between blood pressure, cardiovascular phenotype, and clinical factors using large scale imaging data.
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使用大规模成像数据对血压、心血管表型和临床因素之间的关系进行建模。
DOI：
10.1093/ehjci/jead161
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发表时间：
2023
期刊：
影响因子：
--
通讯作者：
Kart T
中科院分区：
文献类型：
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作者：
Kart T
高血压仍然是最常见的心血管风险之一。然而，筛查的提供和接受以及随后关于如何控制血压升高的建议的可用性仍然很差。2这可能加剧某些群体的健康不平等，包括妇女，她们往往在怀孕期间很早就出现高血压，3以及少数民族群体，他们似乎患高血压相关并发症的比率更高。2在这种临床范例中，Elghazaly等人4在英国生物库成像研究中发表了一项广泛的研究，探讨了与高血压相关的心脏表型，同时考虑了性别和种族。如果同时存在心脏或血管重塑的证据，高血压患者的心血管风险会增加。2未能解释潜在终末器官疾病的进展可能导致疾病状态治疗不足，同时错过了为风险群体提供更个性化护理的机会。3，5英国生物库是一个独特的数据资源，向研究人员开放，提供英国境内的大规模健康和疾病数据。6样本包括50万名参与者，首次参与时年龄超过45岁，其中10万人目前正在接受多器官成像。6目前约有40000个成像数据集可用于研究，包括心脏和血管磁共振7，Elghazaly等人4从中汇编了一套令人印象深刻的质量控制指标。已经部署了一系列分析技术，包括基于深度学习的自动图像分析，涵盖腔室大小、功能测量（包括应变）和心肌特征（如T1标测）。8-10此外，通过谨慎使用英国生物银行数据和初级保健记录之间的联系，已经开发了一个深入的高血压管理的临床图片。6大约有40000名参与者，这是文献中涉及高血压心脏表型的最大研究之一。数据结构，包括人口和生活方式特征的显著异质性，以及疾病的高流行率，使得能够进行详细的关联分析。当然，数据并不完美。97%的参与者是白色种族，成像时的平均年龄为64岁，这限制了
Hypertension remains one of the commonest cardiovascular risks. 1 However, both provision and uptake of screening as well as subsequent availability of advice about how to control elevated blood pressure remain poor. 2 This can exacerbate health inequalities for certain groups including women, who often first present very early in life with hypertension during pregnancy, 3 and ethnic groups, who appear to suffer higher rates of hypertension-related complications. 2 Into this clinical paradigm, Elghazaly et al. 4 have now published an extensive exploration of cardiac phenotypes associated with hypertension in the UK Biobank imaging study taking into account both sex and ethnicity. Cardiovascular risk in those with hypertension is augmented if there is also evidence of cardiac or vascular remodelling. 2 Failure to account for progression of underlying end organ disease may be leading to under treatment of disease state while missing an opportunity to provide more personalized care to groups at risk. 3, 5 UK Biobank is a unique data resource, openly available to researchers, providing large-scale data on health and illness, within the UK. 6 The sample comprises of 500 000 participants, over the age of 45 years at first involvement, of which 100 000 are currently undergoing multiorgan imaging. 6 Around 40 000 imaging data sets are currently available for research including cardiac and vascular magnetic resonance 7 from which Elghazaly et al. 4 have compiled an impressive set of qualitycontrolled metrics. A combination of analysis techniques has been deployed including deep-learning–based automated image analysis that covers chamber sizes, functional measures, including strain, and myocardial characteristics such as T1 mapping. 8–10 Furthermore, through careful use of linkage between UK Biobank data and primary care records, an in-depth clinical picture of hypertension management has been developed. 6With approximately 40 000 participants, this is the one of the largest studies in the literature addressing hypertensive cardiac phenotypes. The data structure, including a significant heterogeneity in demographic and lifestyle characteristics, as well as a high prevalence of conditions, has enabled a detailed associative analysis. Of course, the data are not perfect. Ninety-seven per cent of participants were of a White ethnicity, with an average age at imaging of 64 years, which limits