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心电图左心室肥厚与动脉僵硬度:大岛研究

Electrocardiographic left ventricular hypertrophy and arterial stiffness: the Ohasama study.

作者信息

Watabe Daisuke, Hashimoto Junichiro, Hatanaka Rieko, Hanazawa Tomohiro, Ohba Hiromi, Ohkubo Takayoshi, Kikuya Masahiro, Totsune Kazuhito, Imai Yutaka

机构信息

Department of Clinical Pharmacology and Therapeutics, Tohoku University Graduate School of Pharmaceutical Science and Medicine, Aoba, Aramaki, Sendai, Japan.

出版信息

Am J Hypertens. 2006 Dec;19(12):1199-205. doi: 10.1016/j.amjhyper.2006.05.001.

Abstract

BACKGROUND

Whether arterial stiffness per se contributes to left ventricular hypertrophy (LVH) independently of blood pressure (BP) remains unknown. We examined the relationship between pulse wave velocity (PWV) and LVH in a large population.

METHODS

The PWV was measured between the brachial and ankle regions (baPWV) of 798 individuals. We diagnosed LVH using electrocardiographic criteria: Cornell voltage-duration product >2440 mm x msec or Sokolow-Lyon voltage >38 mm. The participants were initially separated into those with and without LVH [LVH(+) and LVH(-) groups, respectively]. To determine theoretical baPWV, we first constructed a nomogram for the LVH(-) group, calculated the PWV index (measured baPWV - theoretical baPWV) for each individual and then compared the two groups. We also examined the factors associated with LVH(+) using multivariate analyses.

RESULTS

Linear regression analysis revealed that the theoretical baPWV (m/sec) = 0.20 x age (years) + 0.13 x Mean arterial pressure (MAP) (mm Hg) + 0.05 x Heart rate (beats/min) - 11.74 (R(2) = 0.56). The PWV index was greater in the LVH(+) than in the LVH(-) group (P = .025). The baPWV was independently related to LVH(+) along with MAP, medication for hypertension, and for diabetes; a 1 SD (4.3 m/sec) increase in baPWV was associated with a 26% increase in the risk of LVH(+) (P = .022). When LVH(+) risk factors were defined as hypertension, diabetes, and high baPWV (> or =14.6 m/sec), the prevalence of LVH(+) linearly increased with the number of concomitant LVH(+) risk factors (P < .001).

CONCLUSIONS

Arterial stiffness is independently related to electrocardiographically determined LVH in the general population.

摘要

背景

动脉僵硬度本身是否独立于血压(BP)导致左心室肥厚(LVH)尚不清楚。我们在大量人群中研究了脉搏波速度(PWV)与LVH之间的关系。

方法

测量了798名个体肱动脉和踝部之间的PWV(baPWV)。我们采用心电图标准诊断LVH:康奈尔电压-时间乘积>2440 mm×msec或索科洛夫-里昂电压>38 mm。参与者最初被分为有和无LVH的两组[分别为LVH(+)组和LVH(-)组]。为了确定理论baPWV,我们首先为LVH(-)组构建了一个列线图,计算每个个体的PWV指数(测量的baPWV-理论baPWV),然后比较两组。我们还使用多变量分析研究了与LVH(+)相关的因素。

结果

线性回归分析显示,理论baPWV(m/秒)=0.20×年龄(岁)+0.13×平均动脉压(MAP)(mmHg)+0.05×心率(次/分钟)-11.74(R²=0.56)。LVH(+)组的PWV指数高于LVH(-)组(P = 0.025)。baPWV与LVH(+)独立相关,同时还与MAP、高血压用药和糖尿病用药有关;baPWV每增加1个标准差(4.3 m/秒),LVH(+)风险增加26%(P = 0.022)。当将LVH(+)风险因素定义为高血压、糖尿病和高baPWV(≥14.6 m/秒)时,LVH(+)的患病率随伴随的LVH(+)风险因素数量呈线性增加(P < 0.001)。

结论

在一般人群中,动脉僵硬度与心电图确定的LVH独立相关。

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