Gardin Julius M, Brunner Debra, Schreiner Pamela J, Xie Xiaoyuan, Reid Cheryl L, Ruth Karen, Bild Diane E, Gidding Samuel S
Division of Cardiology, Department of Medicine, University of California, Irvine, California, USA.
J Am Coll Cardiol. 2002 Aug 7;40(3):529-35. doi: 10.1016/s0735-1097(02)01973-3.
The goal of this study was to determine the presence and correlates of change (Delta) in left ventricular (LV) mass by echocardiography in young adults.
Left ventricular mass is known to be a powerful independent predictor for cardiovascular disease events in adults. However, little is known about Delta in LV mass over time in young adults.
Coronary Artery Risk Development in Young Adults (CARDIA) is a multicenter, longitudinal, population-based study of black and white men and women who were ages 23 to 35 at the time of their initial two-dimensionally directed M-mode echocardiography exam (year 5); half the cohort had a repeat echocardiography exam five years later (year 10). Data were analyzed from 1,189 participants who had paired echocardiography studies. To minimize reader variability, blinded measurements on initial and repeat echocardiography were performed nearly contemporaneously by the same reader.
In multilinear regression analyses, significant (p < 0.05) predictors of year 10 two-dimensional guided M-mode LV mass included initial LV mass, initial body mass index (BMI) and change in BMI for all race/gender subgroups. Initial systolic blood pressure (SBP) was a significant predictor of year 10 LV mass in white men and black women; change in SBP was significant in black women with a trend towards significance in white women. Left ventricular mass remained constant in all race/gender subgroups, except black women, where it increased (by 5.9 g [mean]). Black women also had the largest increases in BMI and SBP. In black women, a five-year weight gain of 20 pounds and a 15-mm Hg increase in SBP would be expected to be associated with a 9% to 12% increase in LV mass.
Particularly in black women, weight and blood pressure control may be important community health and treatment goals to prevent LV hypertrophy.
本研究的目的是通过超声心动图确定年轻成年人左心室（LV）质量变化（Delta）的存在及其相关因素。
左心室质量是成人心血管疾病事件的有力独立预测指标。然而，关于年轻成年人随时间推移左心室质量的Delta情况知之甚少。
年轻成年人冠状动脉风险发展研究（CARDIA）是一项多中心、纵向、基于人群的研究，研究对象为最初进行二维导向M型超声心动图检查（第5年）时年龄在23至35岁的黑人和白人男性及女性；一半队列在五年后（第10年）进行了重复超声心动图检查。对1189名进行了配对超声心动图研究的参与者的数据进行了分析。为尽量减少读者差异，同一读者几乎同时对初始和重复超声心动图进行了盲法测量。
在多线性回归分析中，对于所有种族/性别亚组，第10年二维导向M型左心室质量的显著（p<0.05）预测因素包括初始左心室质量、初始体重指数（BMI）和BMI变化。初始收缩压（SBP）是白人男性和黑人女性第10年左心室质量的显著预测因素；SBP变化在黑人女性中显著，在白人女性中有显著趋势。除黑人女性左心室质量增加（平均增加5.9g）外，所有种族/性别亚组的左心室质量保持不变。黑人女性的BMI和SBP增加也最大。在黑人女性中，预计体重五年增加20磅和SBP升高15mmHg会使左心室质量增加9%至12%。
特别是在黑人女性中，控制体重和血压可能是预防左心室肥厚的重要社区健康和治疗目标。
