Dekkers Caroline, Treiber Frank A, Kapuku Gaston, Van Den Oord Edwin J C G, Snieder Harold
Georgia Prevention Institute, Medical College of Georgia, Augusta.
Hypertension. 2002 May;39(5):943-51. doi: 10.1161/01.hyp.0000015612.73413.91.
Increased left ventricular mass has been established as a strong risk factor for cardiovascular morbidity and mortality. To evaluate growth of left ventricular mass from childhood into early adulthood and its possible sociodemographic, anthropometric, and hemodynamic moderators, individual growth curves across age of left ventricular mass were created for 687 African American and European American males and females with a maximum of 10 annual assessments (age, 8.2 to 27.5 years). African Americans and males had significantly greater left ventricular mass (P<0.001) than did European Americans and females, respectively. Males also showed a larger rate of change in left ventricle mass than did girls (P<0.001). The ethnicity and gender effects on left ventricular mass only became apparent in early adolescence, and they persisted when controlling for socioeconomic status and anthropometric and hemodynamic variables. Body mass index and height were the strongest anthropometric predictors, and pulse pressure was the strongest hemodynamic predictor of left ventricular mass. Although significant, the contribution of pulse pressure to the prediction of left ventricular mass was small, once body mass index and height were entered into the model. The results of the present study suggest that increased left ventricular mass in boys and African Americans has its origin in late childhood. Apart from these ethnicity and gender effects, individual differences in cardiac growth can mainly be explained by body growth and increases in general adiposity.
左心室质量增加已被确认为心血管疾病发病率和死亡率的一个重要危险因素。为了评估从儿童期到成年早期左心室质量的增长情况及其可能的社会人口统计学、人体测量学和血流动力学调节因素,我们为687名非裔美国人和欧洲裔美国男性及女性绘制了左心室质量随年龄变化的个体生长曲线,这些个体最多接受了10次年度评估(年龄范围为8.2至27.5岁)。非裔美国人及男性的左心室质量分别显著高于欧洲裔美国人及女性(P<0.001)。男性左心室质量的变化率也高于女孩(P<0.001)。种族和性别对左心室质量的影响仅在青春期早期才明显显现,并且在控制了社会经济地位、人体测量学和血流动力学变量后仍然存在。体重指数和身高是最强的人体测量学预测指标,脉压是左心室质量最强的血流动力学预测指标。尽管脉压具有显著性,但一旦将体重指数和身高纳入模型,脉压对左心室质量预测的贡献就很小。本研究结果表明,男孩和非裔美国人左心室质量增加始于儿童晚期。除了这些种族和性别影响外,心脏生长的个体差异主要可以由身体生长和总体肥胖增加来解释。