Left ventricular mass predicts heart failure not related to previous myocardial infarction: the Cardiovascular Health Study
Left ventricular mass predicts heart failure not related to previous myocardial infarction: the Cardiovascular Health Study
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DOI：
10.1093/eurheartj/ehm605
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发表时间：
2008-03-01
影响因子：
39.3
通讯作者：
Maurer, Mathew S.
中科院分区：
文献类型：
--
作者：
de Simone, Giovanni;Gottdiener, John S.;Maurer, Mathew S.
目的：左心室肥厚（LVH）与非心肌梗死（MI）所致心力衰竭（HF）的关系尚未明确。我们评估LVH是否是MI非依赖性HF的独立预测因子。方法和结果LVH通过超声心动图LV质量指数评估（单位：g/m（2.7））和LV质量过量（eLVM，占观察值的%）相对于性别、每搏功和身高预测的量，在2078例心血管健康研究的参与者中使用经验证的公式，这些参与者没有普遍的MI和正常的收缩功能。eLVM增加与左房内径和同心圆几何构型进行性增加、收缩功能降低（P < 0.0001）和舒张功能降低（P < 0.04）相关。在调整年龄、性别、肥胖、糖尿病、高血压和抗高血压治疗并考虑MI事件后，eLVM每增加1%，HF的风险就会增加1%，LV质量指数每增加g/m（2.7），HF的风险就会增加3%（均P < 0.0001）。结果得到证实时，也C-反应蛋白和措施的收缩期（endocardial shortening）和舒张功能（类别的E/A比）被添加到考克斯model.Conclusion在老年人群中，左心室肥厚，测量左心室质量指数或eLVM是一个独立的预测事件HF不相关的流行或事件MI。
Aims The relationship of left ventricular hypertrophy (LVH) to incident heart failure (HF) not attributable to myocardial infarction (MI) has not been defined. We assessed whether LVH is an independent predictor of MI-independent HF.Methods and results LVH was assessed by echocardiographic LV mass index (in g/m(2.7)) and excess of LV mass (eLVM, in % of the observed value) relative to the amount predicted by sex, stroke work, and height, using a prognostically validated equation in 2078 participants of Cardiovascular Health Study without prevalent MI and normal systolic function. Increasing eLVM was associated with progressively increasing left atrial dimension and concentric geometry, decreasing systolic (P < 0.0001), and diastolic function (P < 0.04). After adjustment for age, sex, obesity, diabetes, hypertension, and antihypertensive therapy, and accounting for by incident MI, hazard of HF increased by 1% for each 1% increase in eLVM and by 3% for each g/m(2.7) increase in LV mass index (both P < 0.0001). The results were confirmed when also C-reactive protein and measures of systolic (endocardial shortening) and diastolic function (categories of E/A ratio) were added to the Cox models.Conclusion In an elderly population, LVH, measured as LV mass index or eLVM is an independent predictor of incident HF not related to prevalent or incident MI.