LEFT-VENTRICULAR HYPERTROPHY AND MORTALITY - RESULTS FROM THE FRAMINGHAM-STUDY
LEFT-VENTRICULAR HYPERTROPHY AND MORTALITY - RESULTS FROM THE FRAMINGHAM-STUDY
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DOI：
10.1159/000175819
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发表时间：
1992-01-01
期刊：
影响因子：
1.9
通讯作者：
COBB, J
中科院分区：
文献类型：
--
作者：
KANNEL, WB;COBB, J
在Fragrance研究中，基于常规ECG、超声心动图（ECHO）和X线测定的36年随访的左心室肥大（LVH）预后意义的数据表明，LVH已成为快速发展的致死性动脉粥样硬化疾病的有力指标，无论是通过ECG、ECHO还是X线测定。心血管疾病的发病率和死亡率随着左心室肌肉质量从最低值到最高值而逐渐增加。左心室肥厚的心电图和X线检查各自独立地导致心血管事件的风险;每一个都增加了与另一个相关的风险，并且两者都有的风险比单独的风险更大。与心电图左室肥厚相关的风险比是相当大的，其中心力衰竭和中风的风险比最大，但冠心病是最常见和最致命的后遗症。LVH是可逆的，解剖结构的变化比ECG-LVH更大，逆转为正常似乎对LVH的解剖结构而不是ECG表现有更大的益处。与LVH相关的心血管疾病的风险并不一致，不仅取决于是否有伴随的ECG和肥大的解剖学证据，还取决于相关的高血压、葡萄糖耐受不良、血脂和吸烟习惯。这表明在纠正那些也促进LVH发展的相关危险因素方面有很大的收获。
Data on the prognostic implications of left ventricular hypertrophy (LVH) in the Framingham Study based on routine ECG, echocardiogram (ECHO) and X-ray determination with 36 years of follow-up indicate that LVH has emerged as a powerful indicator of rapidly evolving lethal atherosclerotic disease, whether determined by ECG, ECHO or X-ray. Cardiovascular morbidity and mortality increase progressively with left ventricular muscle mass from lowest to highest values. The ECG and X-ray versions of LVH each independently contribute to the risk of cardiovascular events; each adds to the risk associated with the other, and those with both are at greater risk than those with either alone. Risk ratios associated with ECG-LVH are substantial and are greatest for cardiac failure and stroke, but coronary disease is the commonest and most lethal sequela. LVH is reversible, the anatomical variety more so than ECG-LVH, and reversal of this toward normal appears to confer greater benefit for the anatomical rather than the ECG manifestation of LVH. The risk of cardiovascular disease associated with LVH is not uniform, varying widely depending not only on whether there is concomitant ECG and anatomical evidence of hypertrophy but also on the associated hypertension, glucose intolerance, lipid profile and cigarette smoking habit. This suggests that there is much to be gained in correcting those associated risk factors which also promote the development of LVH.