Development of a nomogram for screening the risk of left ventricular hypertrophy in Chinese hypertensive patients.
Development of a nomogram for screening the risk of left ventricular hypertrophy in Chinese hypertensive patients.
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开发列线图筛查中国高血压患者左心室肥厚风险
DOI：
10.1111/jch.14240
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发表时间：
2021-06
期刊：
影响因子：
--
通讯作者：
Xie L
中科院分区：
文献类型：
--
作者：
Ye C;Wang T;Gong J;Cai X;Lian G;Luo L;Wang H;Xie L
左心室肥厚（LVH）是高血压病患者心血管疾病发病率和死亡率的重要危险因素。因此，早期识别高危患者是必要的。本研究的目的是通过设计列线图来估计中国高血压患者左室肥厚的风险。将832例高血压病患者按是否存在左室肥厚分为两组。最小绝对收缩和选择算子（LASSO）回归和多变量逻辑回归的最佳变量选择和诺模图的构建。使用受试者工作特征（ROC）曲线、校准曲线和决策曲线分析评价辨别力、校准和临床有用性。使用bootstrap方法进行内部验证。列线图包括五个预测因子，即性别、高血压病程、年龄、体重指数（BMI）和收缩压。ROC曲线下面积（AUC）为0.724（95% CI：0.687 - 0.761），表明具有中度辨别力。校准曲线显示预测的LVH和实际LVH概率之间非常一致。根据决策曲线分析和诺模图，风险阈值在5%至72%之间是临床有益的。通过1000个样本的bootstrapping内部验证，显示出良好的C-指数为0.715，这表明训练集和测试集的预测能力是一致的。我们的研究提出了一个诺模图，可以用来快速评估中国高血压患者左室肥厚的风险。该工具可用于识别LVH高风险患者。需要进一步的研究来确定这个诺模图的稳定性和适用性。我们的研究提出了一个诺模图，可以用来快速评估中国高血压患者的左室肥厚风险。该工具可用于识别LVH高风险患者。
Left ventricular hypertrophy (LVH) is an important risk factor for cardiovascular morbidity and mortality in hypertensives. Therefore, early identification of at‐risk patients is necessary. The objective of this study was to estimate the risk of LVH among Chinese hypertensives by designing a nomogram. 832 hypertensives were divided into two groups based on the presence of LVH. The least absolute shrinkage and selection operator (LASSO) regression and multivariable logistic regression were successively applied for optimal variable selection and nomogram construction. Discrimination power, calibration, and clinical usefulness were evaluated using the receiver operating characteristic (ROC) curve, calibration curve, and decision curve analysis. Internal validation was performed using the bootstrap method. The nomogram included five predictors, namely gender, duration of hypertension, age, body mass index (BMI), and systolic blood pressure. The area under the ROC curve (AUC) was 0.724 (95% CI: 0.687‐0.761), indicating moderate discrimination. The calibration curve showed an excellent agreement between the predicted LVH and the actual LVH probability. The risk threshold between 5% and 72% according to the decision curve analysis, and the nomogram is clinically beneficial. Internal validation by bootstrapping with 1000 samples showed a good C‐index of 0.715, which suggested that the predictive abilities for the training set and testing set were in consistency. Our study proposed a nomogram that can be utilized to assess the LVH risk rapidly for Chinese hypertensives. This tool could be useful in identifying patients at high risk for LVH. Further studies are required to ascertain the stability and applicability of this nomogram. Our study proposed a nomogram that can be utilized to assess the LVH risk rapidly for Chinese hypertensive patients. This tool could be useful in identifying patients at high risk for LVH.
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