Toprak Ahmet, Reddy Jagadeesh, Chen Wei, Srinivasan Sathanur, Berenson Gerald
Tulane Center for Cardiovascular Health, New Orleans, LA, USA.
Am J Cardiol. 2009 Apr 1;103(7):978-84. doi: 10.1016/j.amjcard.2008.12.011.
Differences in geometric adaptation of the left ventricle and associated cardiovascular risk may reflect the differential effects of classic risk factors and arterial stiffness on the left ventricle. In the present study, the influence of cardiovascular risk factors and arterial stiffness indexes on left ventricular (LV) geometry types were studied in a large community-based cohort of young adults. As part of the Bogalusa Heart Study, echocardiographic examinations of the heart were performed on 786 black and white adults (age range 24 to 43 years, average 36; 42% men, 70% white). Arterial stiffness indexes of the study cohort included aorta-femoral pulse wave velocity, carotid artery elastic modulus, and arterial compliance using tonometry. Pulse pressure in young adults with concentric LV hypertrophy (47 +/- 11 mm Hg) was significantly higher than in those with eccentric LV hypertrophy (40 +/- 8 mm Hg) and normal geometry (37 +/- 7 mm Hg). Multinomial logistic regression analysis showed that widened pulse pressure, the presence of diabetes mellitus, and increased body mass index were associated with concentric LV hypertrophy compared with normal geometry. Similarly, higher Peterson's and Young's elastic modulus of the carotid arteries and lower large- and small-artery compliance, in addition to increased body mass index, diabetes mellitus, and black race, were associated with concentric LV hypertrophy in young adults. In conclusion these data suggested that concentric LV hypertrophy was associated with widened pulse pressure, increased arterial stiffness, and decreased arterial compliance in young adults.
左心室的几何适应性差异及相关心血管风险可能反映了经典风险因素和动脉僵硬度对左心室的不同影响。在本研究中,我们在一个以社区为基础的大型年轻成人队列中,研究了心血管风险因素和动脉僵硬度指标对左心室(LV)几何类型的影响。作为博加卢萨心脏研究的一部分,对786名黑人和白人成年人(年龄范围24至43岁,平均36岁;42%为男性,70%为白人)进行了心脏超声心动图检查。研究队列的动脉僵硬度指标包括主动脉 - 股动脉脉搏波速度、颈动脉弹性模量以及使用眼压计测量的动脉顺应性。同心性左心室肥厚的年轻成年人的脉压(47±11 mmHg)显著高于偏心性左心室肥厚者(40±8 mmHg)和几何形态正常者(37±7 mmHg)。多项逻辑回归分析显示,与正常几何形态相比,脉压增宽、患有糖尿病以及体重指数增加与同心性左心室肥厚相关。同样,除体重指数增加、患有糖尿病和黑人种族外,较高的颈动脉彼得森弹性模量和杨氏弹性模量以及较低的大、小动脉顺应性与年轻成年人的同心性左心室肥厚相关。总之,这些数据表明,年轻成年人的同心性左心室肥厚与脉压增宽、动脉僵硬度增加和动脉顺应性降低有关。