RELATION OF LEFT-VENTRICULAR MASS AND GEOMETRY TO MORBIDITY AND MORTALITY IN UNCOMPLICATED ESSENTIAL-HYPERTENSION
RELATION OF LEFT-VENTRICULAR MASS AND GEOMETRY TO MORBIDITY AND MORTALITY IN UNCOMPLICATED ESSENTIAL-HYPERTENSION
复制标题
DOI：
10.7326/0003-4819-114-5-345
复制
发表时间：
1991-03-01
影响因子：
39.2
通讯作者：
LARAGH, JH
中科院分区：
文献类型：
--
作者：
KOREN, MJ;DEVEREUX, RB;LARAGH, JH
目的：为了评估预后意义的左心室质量和几何形状在最初健康的人原发性hypertension.Design：一个前瞻性确定的cohol.Setting：大学医学center.Patients：208例原发性高血压和预先存在的心脏病患者进行了评估，使用超声心动图在1976年和1981年之间的观察研究。253名受试者或他们的家庭成员（90%）进行了随访采访，平均10.2年后，最初的超声心动图获得了27例患者失去随访的生存状态，确定使用国家死亡指数data.Measurements和主要结果：左心室质量超过125 g/m2的69 253例（27%）。有左心室肥厚的患者发生心血管事件的比例高于无左心室肥厚的患者（26%比12%; p = 0.006）。心室质量增加的患者心血管死亡（14%比0.5%; P < 0.001）和全因死亡（16%比2%; P = 0.001）的风险也更高。心电图左心室肥大不能预测风险。左心室几何结构正常的患者不良结局最少（无心源性死亡; 11%发生病态事件），向心性肥厚的患者不良结局最多（死亡21%;病态事件31%）。在多变量分析中，只有年龄和左心室质量，但不是性别，血压，或血清胆固醇水平独立预测所有三个outcome measurements.Conclusions：超声心动图确定的左心室质量和几何结构分层风险的原发性高血压患者的独立和更强烈的血压或其他潜在的可逆的危险因素，并可能有助于分层需要强化治疗。
Objective: To assess the prognostic significance of left ventricular mass and geometry in initially healthy persons with essential hypertension.Design: An observational study of a prospectively identified cohort.Setting: University medical center.Patients: Two hundred and eight patients with essential hypertension and pre-existing cardiac disease were evaluated using echocardiography between 1976 and 1981. Two hundred and fifty-three subjects or their family members (90%) were contacted for a follow-up interview an average of 10.2 years after the initial echocardiogram was obtained; the survival status of 27 patients lost to follow-up was ascertained using National Death Index data.Measurements and Main Results: Left ventricular mass exceeded 125 g/m2 in 69 of 253 patients (27%). Cardiovascular events occurred in a higher proportion of patients with than without left ventricular hypertrophy (26% compared with 12%; p = 0.006). Patients with increased ventricular mass were also at higher risk for cardiovascular death (14% compared with 0.5%; P < 0.001) and all-cause mortality (16% compared with 2%; P = 0.001). Electrocardiographic left ventricular hypertrophy did not predict risk. Patients with normal left ventricular geometry had the fewest adverse outcomes (no cardiac deaths; morbid events in 11%), and those with concentric hypertrophy had the most (death in 21%; morbid events in 31%). In a multivariate analysis, only age and left ventricular mass-but not gender, blood pressure, or serum cholesterol level-independently predicted all three outcome measures.Conclusions: Echocardiographically determined left ventricular mass and geometry stratify risk in patients with essential hypertension independently of and more strongly than blood pressure or other potentially reversible risk factors and may help to stratify the need for intensive treatment.