Diastolic dysfunction and left atrial volume - A population-based study
Diastolic dysfunction and left atrial volume - A population-based study
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DOI：
10.1016/j.jacc.2004.09.054
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发表时间：
2005-01-04
影响因子：
24
通讯作者：
Redfield, MM
中科院分区：
文献类型：
--
作者：
Pritchett, AM;Mahoney, DW;Redfield, MM
目的 我们在一项基于人群的研究中检查了舒张功能与与体表面积 (LAVi) 相关的左心房容积之间的关联。 背景 心房扩大已被建议作为舒张功能障碍 (DD) 严重程度和持续时间的标志。然而，DD 和心房扩大之间的关联及其对人群的个体预后影响尚不清楚。 方法 对明尼苏达州奥姆斯特德县年龄大于或等于 45 岁的居民 (n = 2,042) 进行横断面样本进行全面的多普勒超声心动图和病历审查。 结果 LAVi 随着 DD 恶化而增加：23 +/- 6 ml/m(2)（正常）、25 +/- 8 ml/m(2)（I 级 DD）、31 +/- 8 ml/m(2)（II 级 DD）、48 +/- 12 ml/m(2)（III 至 IV 级 DD）。在双变量分析中，年龄、左心室质量指数和 DD 等级呈正相关，而女性性别和射血分数 (EF) 与 LAVi 呈负相关（全部 p < 0.001）。当控制年龄、性别、心血管 (CV) 疾病、EF 和左心室质量时，II 级 DD 与 24% 相关，III 至 IV 级 DID 与 LA 体积增大 62% 相关（两者均 p < 0.0001）。 LAVi 检测 I 级、II 级或 III 级至 IV 级 DD 的接收者-操作者特征曲线下面积分别为 0.57、0.81 和 0.98。 DD 和 LAVi 均可预测全因死亡率，但在控制 DD 时，LAVi 并不是死亡率的独立预测因子。 结论 这些数据表明 DD 有助于 LA 重塑。事实上，DD 是死亡率的更强预测因子；据推测，它更好地反映了心血管疾病对普通人群的影响。 (C) 2005 年由美国心脏病学会基金会资助。
OBJECTIVES We examined the association between diastolic function and left atrial volume indexed to body surface area (LAVi) in a population-based study.BACKGROUND Atrial enlargement has been suggested as a marker of the severity and duration of diastolic dysfunction (DD). However, the association between DD and atrial enlargement and their individual prognostic implications in the population is poorly defined.METHODS A cross-sectional sample of Olmsted County, Minnesota, residents greater than or equal to45 years of age (n = 2,042) underwent comprehensive Doppler echocardiograyhy and medical record review.RESULTS The LAVi increased with worsening DD: 23 +/- 6 ml/m(2) (normal), 25 +/- 8 ml/m(2) (grade I DD), 31 +/- 8 ml/m(2) (grade II DD), 48 +/- 12 ml/m(2) (grades III to IV DD). In bivariate analyses, age, left ventricular mass index, and DD grade were positively associated, whereas female gender and ejection fraction (EF) were inversely associated with LAVi (p < 0.001 for all). When controlling for age, gender, cardiovascular (CV) disease, EF, and left ventricular mass, grade II DD was associated with a 24%, and grade III to IV DID was associated with a 62% larger LA volume (p < 0.0001 for both). The area under the receiver-operator characteristic curve for LAVi to detect grade I, grade II, or grade III to IV DD was 0.57, 0.81, and 0.98, respectively. Both DD and LAVi were predictive of all-cause mortality, but when controlling for DD, LAVi was not an independent predictor of mortality.CONCLUSIONS These data suggest that DD contributes to LA remodeling. Indeed, DD is a stronger predictor of mortality; presumably it better reflects the impact of CV disease within the general population. (C) 2005 by the American College of Cardiology Foundation.