Which arterial and cardiac parameters best predict left ventricular mass?
Which arterial and cardiac parameters best predict left ventricular mass?
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DOI：
10.1161/01.cir.98.5.422
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发表时间：
1998-08-04
期刊：
影响因子：
37.8
通讯作者：
Yin, FCP
中科院分区：
文献类型：
--
作者：
Chen, CH;Ting, CT;Yin, FCP
背景：许多心血管和非心血管参数被认为是左心室质量（LVM）的决定因素。复杂的相互作用需要同时测量和考虑每个因素，以确定它们对LVM的个人和集体影响。我们进行了如此全面的研究。方法与结果分析1315例血压正常或未经治疗的高血压患者的人体测量、心脏大小和收缩力、动脉结构和功能以及生活方式、体力活动和膳食盐摄入量等指标对LVM的影响（采用二维引导m型超声心动图）。评估了许多心脏和动脉因素的影响。在单变量分析中，几乎所有测量的非心血管、心脏和动脉变量都与LVM显著相关。在多元线性回归分析中，考虑到年龄、性别、体质、空腹血清c肽水平、膳食盐、体力活动和生活方式等因素，最佳多元线性回归主效应模型的调整模型r(2)为0.740，其中98%的模型方差由LVM的5个独立决定因素解释：脑卒中容量（49.6%）、收缩压（30.7%）、收缩力（14.7%）、体重指数（1.8%）和主动脉根径（1.6%）。只有当血压从模型中去除时，其他提出的动脉指标才是LVM的重要独立决定因素，即使这样，这些指标不仅导致较弱的预测，而且只占LVM总方差的很小百分比。结论：在大量人群中，我们(1)证实年龄、体质和一些动脉结构和功能指标是LVM的独立决定因素；(2)发现主动脉直径是LVM的独立结构决定因素；(3)证明了动脉功能的衍生测量的影响很小，并没有提供比单独血压更好的预测能力；(4)表明，当包括心脏和血管负荷的最佳测量时，最有效的预测指标是左心室大小指数。
Background-Many cardiovascular and noncardiovascular parameters are thought to be determinants of left ventricular mass (LVM). Complicated interactions necessitate the simultaneous measurement and consideration of each to determine their individual and collective impact on LVM. We undertook such a comprehensive study.Methods and Results-Tne influence of anthropometry, cardiac size and contractility, arterial structure and function, as well as indices of lifestyle, physical activity, and dietary salt intake on LVM (by two-dimensionally guided M-mode echocardiography) was analyzed in 1315 Chinese subjects who were either normotensive or had untreated hypertension. Effects of many cardiac and arterial factors were assessed. In univariate analysis, almost all measured noncardiovascular, cardiac, and arterial variables were significantly correlated with LVM. In multivariate linear regression analyses, when age, sex, body habitus, fasting serum C-peptide level, dietary salt, physical activity, and lifestyle were accounted for, the optimum multivariate linear regression main effects model had an adjusted model r(2) of 0.740, with 98% of the model variance accounted for by the 5 independent determinants of LVM: stroke volume (49.6%), systolic blood pressure (30.7%), contractility (14.7%), body mass index (1.8%), and aortic root diameter (1.6%). Other proposed arterial indices were significant independent determinants of LVM only when blood pressure was removed from the model and, even then, these indices not only resulted in less powerful prediction but also accounted for only a very small percentage of the total variance of LVM.Conclusions-In a large population, we (1) confirmed that age, body habitus, and some indexes of arterial structure and function are independent determinants of LVM; (2) found aortic diameter to be an independent structural determinant of LVM; (3) demonstrated that the effects of the derived measures of arterial function were small and provided no better predictive power than blood pressure alone; and (4) showed that when the best measures of cardiac and vascular load were included, the single most potent predictor was an index of left ventricular size.