超声心动图检测到的左心室肥厚：泰国老年男性和女性中的患病率及危险因素

Echocardiographically detected left ventricular hypertrophy: prevalence and risk factors in Thai elderly men and women.

作者信息

Chantra S, Bhuthong B

机构信息

Sakaeo Crown Prince Hospital, Ministry of Public Health, Thailand.

出版信息

J Med Assoc Thai. 2000 Sep;83(9):1082-94.

PMID:11075977

Abstract

OBJECTIVE

To find the prevalence of and risk factors associated with echocardiographically determined left ventricular hypertrophy (LVH) in the general Thai elderly men and women.

BACKGROUND

The prevalence of LVH and risk factors is not at present available for precise assessment of the seriousness in the general Thai population. The prevalence of LVH may be influenced by race, obesity, age, sex and hypertension. Their effects on left ventricular mass (LVM) have not been defined in the general Thai population.

METHOD

A cohort of 157 subjects 60 years of age and over was studied. LVM was calculated using the modification of the ASE cube formula. Criteria for LVH were based on various LVM indexation using the published conventional partition values. Univariate and multivariate analyses with various variables were studied.

RESULT

M-mode echocardiographic studies of adequate quality were obtained in 125 (80%) of 157 participants. Prevalence of LVH depended on the different types of indexation. LVH defined by 1) unindexes LVM (> or = 259g in men (M), > or = 166 g in women (F)) was 35(28%); 2) defined by LVM/BSA (> or = 131 g/m2 in M, > or = 100g/m2 in F) 63 (50%); 3) (> or = 117 g/m2 in M, > or = 104 g/m2 in F) 68 (54%); 4) (> or = 125 g/m2 in both M and F) 43 (34%); 5) defined by LVM/ height (> or = 143 g/m in M and > or = 102 g/m in F) 49 (39%); 6) (> or = 126 g/m in M and > or = 105 g/m in F) 52 (42%); 7) defined by LVM/height2.7 (> or = 51 g/m2.7 in both M and F) 62 (50%); 8) (> or = 50 g/m2.7 in M, > or = 47 g/m2.7 in F) 77 (62%). The following variables independently predicted LVM in descending order of statistical significance: BW, BMI, SBP, PP, height were the most significant (p < 0.01), whereas, DBP and gender made smaller contributions and age showed no correlation. In multivariate analysis only BW and PP showed significant correlation with LVM in the total population.

CONCLUSION

LVH is a common echocardiographic finding in Thai elderly (28-62%). Body weight and PP are major risk factors. These findings support weight reduction and PP control for prevention or regression of this condition. Indexing for BSA (LVM/BSA >117 g/m2 in M, > or = 104 g/m2 in F) reduces LVH variability in underweight, normal weight and overweight subgroups as well as sexes.

摘要

目的

探寻泰国普通老年男性和女性中经超声心动图测定的左心室肥厚（LVH）的患病率及相关危险因素。

背景

目前尚无LVH患病率及危险因素的相关数据用于精确评估泰国普通人群中该病的严重程度。LVH的患病率可能受种族、肥胖、年龄、性别和高血压影响。在泰国普通人群中，它们对左心室质量（LVM）的影响尚未明确。

方法

对157名60岁及以上的受试者进行队列研究。使用美国超声心动图学会（ASE）立方公式的改良版计算LVM。LVH的标准基于使用已发表的传统划分值的各种LVM指数化方法。研究了各种变量的单因素和多因素分析。

结果

157名参与者中有125名（80%）获得了质量足够的M型超声心动图研究结果。LVH的患病率取决于不同类型的指数化方法。LVH的定义如下：1）未指数化的LVM（男性（M）≥259g，女性（F）≥166g）时患病率为35（28%）；2）由LVM/体表面积（BSA）（男性≥131g/m²，女性≥100g/m²）定义时为63（50%）；3）（男性≥117g/m²，女性≥104g/m²）时为68（54%）；4）（男性和女性均≥125g/m²）时为43（34%）；5）由LVM/身高（男性≥143g/m，女性≥102g/m）定义时为49（39%）；6）（男性≥126g/m，女性≥105g/m）时为52（42%）；7）由LVM/身高².⁷（男性和女性均≥51g/m².⁷）定义时为62（50%）；8）（男性≥50g/m².⁷，女性≥47g/m².⁷）时为77（62%）。以下变量按统计学意义从高到低独立预测LVM：体重（BW）、体重指数（BMI）、收缩压（SBP）、脉压（PP）、身高最为显著（p<0.01），而舒张压（DBP）和性别影响较小，年龄无相关性。在多因素分析中，仅BW和PP在总体人群中与LVM显著相关。