Different normalizations for body size and population attributable risk of left ventricular hypertrophy: The MAVI study
Different normalizations for body size and population attributable risk of left ventricular hypertrophy: The MAVI study
复制标题
DOI：
10.1016/j.amjhyper.2005.05.027
复制
发表时间：
2005-10-01
影响因子：
3.2
通讯作者：
Verdecchia, P
中科院分区：
文献类型：
--
作者：
de Simone, G;Devereux, RB;Verdecchia, P
背景：不同的左心室（LV）质量与体型的正常化方法确定了大致相似的心血管不良结局的相对风险，但左心室肥厚的患病率不同(H)。来自高肥胖患病率人群的初步结果表明，当左室质量根据身高异速生长能力归一化时，LVH的人群归因风险百分比（PAR%）显着更高。方法：我们计算了MAssa ventricular sinistra ' Ipertensione （MAVI）研究队列（n = 1019, 62%女性）中LVH的不同定义的PAR%，该队列的肥胖患病率较低（22%，II类和III类肥胖分别只有3%和0.1%）。53名参与者（5.2%）发生了复合致死性和非致死性心血管事件。结果：LVH患病率在28% - 56%之间，基于身高的正常化值略高。不同的左室质量指数测量值经年龄和性别调整后的风险比在1.37 ~ 1.44之间。不同归一化方法的PAR%没有显著差异（在47%和56%之间），基于高度的方法总体上显示出与基于体表面积的归一化相似的性能。结论：在大量肥胖患病率较低的高血压患者的临床人群中，由于左室肥大导致的人群风险与左室质量与体型的归一化类型没有显著差异。基于身高的方法和基于体表面积的方法效果一样好。我们认为，高血压人群中肥胖的患病率可能会显著影响通过不同的左室质量正常化方法确定的LVH人群风险差异。
Background: Different methods of normalizing left ventricular (LV) mass for body size identify generally similar relative risks of adverse cardiovascular outcome but with variable prevalences of LV hypertrophy (H). Preliminary results from a population with high prevalence of obesity suggest that the population attributable-risk percent (PAR%) of LVH is substantially higher when LV mass is normalized for allometric power of height.Methods: We calculated the PAR% of LVH by different definitions in the cohort of the MAssa Ventricolare sinistra nell' Ipertensione (MAVI) study (n = 1019, 62% women), a population with low prevalence of obesity (22%, with only 3% and 0.1% in class II and class III obesity, respectively). Composite fatal and nonfatal cardiovascular events occurred in 53 participants (5.2%).Results: Prevalence of LVH was between 28% and 56%, with slight greater values for height-based normalization. Age- and sex-adjusted hazard ratios were comprised between 1.37 and 1.44 for different measures of LV mass index. The PAR% was not meaningfully different among the different methods of normalization (between 47% and 56%), and height-based methods showed in general a performance similar to body surface area-based normalizations.Conclusions: In a large clinical population of hypertensive subjects with low prevalence of obesity, population risk attributable to LV hypertrophy was not meaningfully different in relation to the type of normalization of LV mass for body size. Height-based methods perform as well as body surface area-based ones. We suggest that the prevalence of obesity in hypertensive populations might substantially influence differences in population risk attributable to LVH identified by different methods of normalizing LV mass.