Determinants of left ventricular diastolic function-The Cardiovascular Risk in Young Finns Study
Determinants of left ventricular diastolic function-The Cardiovascular Risk in Young Finns Study
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DOI：
10.1111/echo.14321
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发表时间：
2019-05-01
影响因子：
1.5
通讯作者：
Raitakari, Olli T.
中科院分区：
文献类型：
--
作者：
Heiskanen, Jarkko S.;Ruohonen, Saku;Raitakari, Olli T.
左心室（LV）舒张功能降低与全因死亡率和心力衰竭风险增加相关。左心室舒张功能的决定因素主要在老年人群中进行研究，然而，左心室心力衰竭的起源可能与生命过程中获得的生活方式因素有关。因此，我们研究了芬兰青年心血管风险研究（Young Finns Study）中34-49岁参与者的LV舒张功能的生化、生理和生活方式决定因素。2011年，对1928名参与者（880名男性和1048名女性;年龄34-49岁）进行了临床检查和超声心动图检查。LV舒张功能主要使用E/e比值定义（人群平均值4.8，范围2.1-9.0）。在多变量模型中，收缩压（P < 0.005），女性E/e比值与年龄（P <0.005）、腰围（P = 0.024）、吸烟（P = 0.028）、血清丙氨酸氨基转移酶（P = 0.032）呈正相关，与身高呈负相关（P < 0.005）。此外，与正常心脏几何结构相比，向心性肥厚参与者的E/e比率更高（P < 0.005）。左室舒张功能的其他指标，包括E/A比值和左房容积指数，也显示出与收缩压和年龄的类似强相关性。总之，我们确定收缩压，腰围和吸烟作为可变的决定因素的左心室舒张功能的34-49岁的参与者的年轻芬兰人的研究。
Decreased left ventricular (LV) diastolic function is associated with increased all-cause mortality and risk for a heart failure. The determinants of LV diastolic function have been mainly studied in elderly populations; however, the origin of LV heart failure may relate to the lifestyle factors acquired during the life course. Therefore, we examined biochemical, physiological, and lifestyle determinants of LV diastolic function in 34-49-year-old participants of the Cardiovascular Risk in Young Finns Study (Young Finns Study). In 2011, clinical examination and echocardiography were performed for 1928 participants (880 men and 1048 women; aged 34-49 years). LV diastolic function was primarily defined using E/e-ratio (population mean 4.8, range 2.1-9.0). In a multivariate model, systolic blood pressure (P < 0.005), female sex (P < 0.005), age (P < 0.005), waist circumference (P = 0.024), smoking (P = 0.028), serum alanine aminotransferase (P = 0.032) were directly associated with E/e-ratio, while an inverse association was found for height (P < 0.005). Additionally, a higher E/e-ratio was found in participants with concentric hypertrophy compared to normal cardiac geometry (P < 0.005). Other indicators of the LV diastolic function including E/A-ratio and left atrial volume index showed similarly strong associations with systolic blood pressure and age. In conclusion, we identified systolic blood pressure, waist circumference and smoking as modifiable determinants of the LV diastolic function in the 34-49-year-old participants of the Young Finns Study.