单纯轻度高血压患者左心室向心性重构的预后价值

Prognostic value of left ventricular concentric remodeling in uncomplicated mild hypertension.

作者信息

Pierdomenico Sante D, Lapenna Domenico, Bucci Anna, Manente Bianca M, Cuccurullo Franco, Mezzetti Andrea

机构信息

Dipartimento di Medicina e Scienze dell'Invecchiamento, University Gabriele d'Annunzio, Chieti, Italy.

出版信息

Am J Hypertens. 2004 Nov;17(11 Pt 1):1035-9. doi: 10.1016/j.amjhyper.2004.06.016.

DOI:10.1016/j.amjhyper.2004.06.016

PMID:15533730

Abstract

BACKGROUND

The prognostic value of left ventricular (LV) concentric remodeling in essential hypertension, and particularly in uncomplicated mild hypertension, is not yet completely clear. We investigated cardiovascular outcome in uncomplicated mild hypertensive patients with normal LV geometry and LV concentric remodeling.

METHODS

The occurrence of fatal and nonfatal cardiovascular events was evaluated in 1088 uncomplicated mild hypertensive patients, 751 with normal LV geometry (LV mass index <125 g/m(2) in men and <110 g/m(2) in women and relative wall thickness <0.45) and 337 with LV concentric remodeling (LV mass index <125 g/m(2) in men and <110 g/m(2) in women and relative wall thickness >/=0.45).

RESULTS

During follow-up (4.74 +/- 2.4 years, range 0.5 to 9.7 years) the event rates per 100 patient-years in subjects with normal LV geometry and LV concentric remodeling were 0.69 and 1.87, respectively. After adjustment for other covariates, Cox regression analysis showed that LV concentric remodeling (LV concentric remodeling versus normal LV geometry, RR 1.78, 95% CI 1.02 to 3.1, P < .05) was an independent predictor of cardiovascular events.

CONCLUSION

In a population with uncomplicated mild hypertension, patients with LV concentric remodeling have a worse prognosis than those with normal LV geometry.

摘要

背景

左心室（LV）向心性重构在原发性高血压，尤其是在未合并症的轻度高血压中的预后价值尚未完全明确。我们调查了左心室几何形态正常和左心室向心性重构的未合并症轻度高血压患者的心血管结局。

方法

对1088例未合并症的轻度高血压患者进行了致命和非致命心血管事件的评估，其中751例左心室几何形态正常（男性左心室质量指数<125 g/m²，女性<110 g/m²，相对室壁厚度<0.45），337例有左心室向心性重构（男性左心室质量指数<125 g/m²，女性<110 g/m²，相对室壁厚度≥0.45）。

结果

在随访期间（4.74±2.4年，范围0.5至9.7年），左心室几何形态正常和左心室向心性重构患者每100患者年的事件发生率分别为0.69和1.87。在对其他协变量进行调整后，Cox回归分析显示，左心室向心性重构（左心室向心性重构与左心室几何形态正常相比，RR 1.78，95%CI 1.02至3.1，P<.05）是心血管事件的独立预测因素。