Sex and race differences in right ventricular structure and function: the multi-ethnic study of atherosclerosis-right ventricle study.
Sex and race differences in right ventricular structure and function: the multi-ethnic study of atherosclerosis-right ventricle study.
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DOI：
10.1161/circulationaha.110.985515
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发表时间：
2011-06-07
期刊：
影响因子：
37.8
通讯作者：
Bluemke DA
中科院分区：
文献类型：
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作者：
Kawut SM;Lima JA;Barr RG;Chahal H;Jain A;Tandri H;Praestgaard A;Bagiella E;Kizer JR;Johnson WC;Kronmal RA;Bluemke DA
右心室形态学是预测心肺疾病预后的重要指标，但右心室解剖结构的决定因素尚未得到充分研究。我们在无临床心血管疾病的多种族人群中研究了与右心室形态和功能相关的人口统计学因素。动脉粥样硬化多民族研究（MESA）对5098名参与者进行了心脏磁共振成像（MRI）。RV的体积和质量可用于4204名参与者。采用异速生长法推导了RV参数的规范方程。研究样本（N = 4123），年龄61.5±10.1岁，男性47.5%。年龄越大，右心室质量越低（每十年质量降低约5%），男性与年龄相关的下降幅度大于女性（相互作用p < 0.05）。年龄较大也与较高的右心室射血分数（RVEF）相关，这种关联在种族/民族之间存在差异（交互作用p≤0.01）。总体而言，男性的右心室质量（约8%）和容积大于女性，但RVEF较低（绝对值为4%）（p < 0.001）。非裔美国人右心室质量低于白种人（p≤0.002），而西班牙裔美国人右心室质量高于白种人（p≤0.02）。根据导出的规范方程，7.3% （95%CI, 6.5-8.1%）符合右心室肥大标准，5.9% （95%CI, 5.2-6.6%）符合右心室功能障碍标准。总之，年龄、性别和种族与右心室质量、右心室体积和RVEF的显著差异相关，这可能解释了右心室对心肺疾病的不同反应。
Right ventricular (RV) morphology is an important predictor of outcomes in heart and lung disease, however determinants of RV anatomy have not been well-studied. We examined the demographic factors associated with RV morphology and function in a population-based multiethnic sample free of clinical cardiovascular disease. The Multi-Ethnic Study of Atherosclerosis (MESA) performed cardiac magnetic resonance imaging (MRI) on 5098 participants. RV volumes and mass were available for 4204 participants. Normative equations for RV parameters were derived using an allometric approach. The study sample (N = 4123) was 61.5 ± 10.1 years old and 47.5% male. Older age was associated with lower RV mass (~5% lower mass per decade) with larger age-related decrements in men than in women (p for interaction < 0.05). Older age was also associated with higher RV ejection fraction (RVEF), an association which differed between races/ethnicities (p for interaction ≤ 0.01). Overall, men had greater RV mass (~8%) and larger RV volumes than women, but had lower RVEF (4% in absolute terms) (p < 0.001). African Americans had lower RV mass than Caucasians (p ≤ 0.002), whereas Hispanics had higher RV mass (p ≤ 0.02). Using the derived normative equations, 7.3% (95%CI, 6.5–8.1%) met criteria for RV hypertrophy and 5.9% (95%CI, 5.2–6.6%) had RV dysfunction. In conclusion, age, sex, and race are associated with significant differences in RV mass, RV volumes and RVEF, potentially explaining distinct responses of the RV to cardiopulmonary disease.