Skelton Thomas N, Andrew Michael E, Arnett Donna K, Burchfiel Cecil M, Garrison Robert J, Samdarshi Tandaw E, Taylor Herman A, Hutchinson Richard G
University of Mississippi Medical Center, Jackson, MS, USA.
Echocardiography. 2003 Feb;20(2):111-20. doi: 10.1046/j.1540-8175.2003.03000.x.
Characterization of target organ damage from hypertension is of particular interest in African-Americans, and evidence from electrocardiographic studies suggests that left ventricular hypertrophy is a frequent clinical finding of considerable prognostic importance. Echocardiographic studies may permit more precise characterization of the pathologic impact of hypertension on cardiac structure and function. The objective of this study is to characterize left ventricular (LV) structure including measures of wall thickness, septal thickness, internal dimension, and mass in a middle-aged sample of African-Americans using echocardiography. This study is a cohort (cross-sectional) study in which 2445 middle-aged African-American study participants from a population-based sample initially enrolled by the Atherosclerosis Risk in Communities, Jackson, Mississippi Examination Center in 1987-1989 underwent an M-mode echocardiograpic examination at their third or fourth clinic visit in 1993-1996. Measures of LV mass, even where indexed by size were conspicuously greater in men compared to women, and men exhibited a demonstrably steeper gradient of LV mass across the rather restricted age range of the study. However, when gender specific thresholds for LV hypertrophy were utilized, African-American men appear to have lower prevalence of LV hypertrophy than women. The lowest prevalence of LV hypertrophy was observed in African-American men who did not have hypertension (28.4%). The findings confirm previous suggestions from electrocardiographic investigations that cardiac hypertrophy is common, if not epidemic in middle-aged African-American men and women, whether or not they have hypertension.
高血压所致靶器官损害的特征在非裔美国人中尤为引人关注，心电图研究证据表明，左心室肥厚是一种常见的临床发现，具有相当重要的预后意义。超声心动图研究或许能更精确地描述高血压对心脏结构和功能的病理影响。本研究的目的是利用超声心动图对一组中年非裔美国人样本的左心室（LV）结构进行特征描述，包括测量室壁厚度、室间隔厚度、内径和质量。本研究是一项队列（横断面）研究，1987 - 1989年由密西西比州杰克逊市社区动脉粥样硬化风险研究中心从基于人群的样本中招募的2445名中年非裔美国研究参与者，在1993 - 1996年的第三次或第四次门诊就诊时接受了M型超声心动图检查。即使按大小进行指数化，左心室质量的测量值在男性中也明显高于女性，并且在该研究相当有限的年龄范围内，男性左心室质量的梯度明显更陡。然而，当采用性别特异性的左心室肥厚阈值时，非裔美国男性的左心室肥厚患病率似乎低于女性。在没有高血压的非裔美国男性中，左心室肥厚的患病率最低（28.4%）。这些发现证实了心电图研究先前的提示，即无论是否患有高血压，心脏肥厚在中年非裔美国男性和女性中都很常见，甚至可以说是一种流行病。
