ASSOCIATION OF CAROTID ATHEROSCLEROSIS AND LEFT-VENTRICULAR HYPERTROPHY
ASSOCIATION OF CAROTID ATHEROSCLEROSIS AND LEFT-VENTRICULAR HYPERTROPHY
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DOI：
10.1016/0735-1097(94)00316-i
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发表时间：
1995-01-01
影响因子：
24
通讯作者：
DEVEREUX, RB
中科院分区：
文献类型：
--
作者：
ROMAN, MJ;PICKERING, TG;DEVEREUX, RB
目标.本研究旨在确定一大群无症状高血压和血压正常成年人中颈动脉粥样硬化的患病率，并检查其与左心室肥大存在的关系。背景。心电图和超声心动图左心室肥厚均预测心血管事件和死亡率（包括脑血管疾病）的风险增加，但相关机制尚不清楚。486例（277例血压正常，209例未经治疗的高血压）无心血管疾病临床证据的成年人进行了前瞻性研究，超声心动图测定左心室质量，颈动脉超声检测动脉粥样硬化和测量颈总动脉尺寸。颈动脉粥样硬化发生在16%的血压正常者和23%的高血压受试者中（p < 0.05），并且与年龄较大、收缩压和脉压较高以及左心室质量指数较大相关（[mean +/- SD] 91 +/- 19 vs. 82 +/- 18 g/m2，p < 0.0001）。在校正了年龄和血压的基线差异后，体重的差异仍然存在。左心室肥厚的受试者发生颈动脉粥样硬化的可能性是正常受试者的两倍（35%对18%，p < 0.01）。Logistic回归分析，包括标准危险因素，表明只有年龄和左心室质量指数能独立预测颈动脉斑块的存在，无论是在整个研究组中还是在血压正常和高血压患者中。我们认为，本研究提供了第一个证据表明，超声心动图检测到的较高的左心室质量与颈动脉斑块的存在有关。心脏肥大和全身动脉粥样硬化之间的关联可能有助于左心室肥大患者血管事件高发生率的发病机制。
Objectives. This study was undertaken to determine the preva lence of carotid atherosclerosis in a large group of asymptomatic hypertensive and normotensive adults and to examine its relation to the presence of left ventricular hypertrophy.Background. Both electrocardiographic and echocardiographic left ventricular hypertrophy predict an increased risk of cardiovascular events and mortality, including cerebrovascular disease, but the mechanism of association is unknown.Methods. Four hundred eighty-six (277 normotensive and 209 untreated hypertensive) adults, free of clinical evidence of cardiovascular disease, were studied prospectively with echocardiography to determine left ventricular mass and carotid ultrasound to detect atherosclerosis and to measure common carotid artery dimensions.Results. Carotid atherosclerosis was present in 16% of normotensive and 23% of hypertensive participants (p < 0.05) and was associated with older age, higher systolic and pulse pressures and larger left ventricular mass index ([mean +/- SD] 91 +/- 19 vs. 82 +/- 18 g/m(2), p < 0.0001). The difference in mass persisted after adjustment for baseline differences in age and blood pressure. Subjects with left ventricular hypertrophy were twice as likely to have carotid atheromas (35% vs. 18%, p < 0.01). Logistic regression analyses, including standard risk factors, indicated that only age and left ventricular mass index independently predicted the presence of carotid plaque, both in the entire study group and when normotensive and hypertensive subjects were considered separately.Conclusions. We believe that the present study provides the first evidence that higher left ventricular mass as detected by echocardiography is associated with the presence of carotid plaque. The association between cardiac hypertrophy and systemic atherosclerosis may contribute to the pathogenesis of the high incidence of vascular events that is well documented in patients with left ventricular hypertrophy.