Department of Medicine, Mailman School of Public Health, Columbia University, New York, New York, USA.
J Am Coll Cardiol. 2010 Jan 19;55(3):234-42. doi: 10.1016/j.jacc.2009.08.046.
The purpose of this study was to examine the prevalence of left ventricular hypertrophy (LVH) and left ventricular (LV) remodeling patterns within Hispanic subgroups compared with non-Hispanic whites in the MESA (Multi-Ethnic Study of Atherosclerosis).
Hispanics are the largest and fastest-growing ethnic minority in the U.S., but there are no data on LVH and LV geometry among Hispanic subgroups.
Cardiac magnetic resonance imaging was performed in 4,309 men and women age 45 to 84 years without clinical cardiovascular disease. Hispanics were categorized into subgroups based on self-reported ancestry. LVH was defined as the upper 95th percentile of indexed LV mass in a reference normotensive, nondiabetic, nonobese population, and LV remodeling according to the presence/absence of LVH and abnormal/normal LV mass to LV end-diastolic volume ratio.
Among Hispanic participants, 574 were of Mexican origin, 329 were of Caribbean origin, and 161 were of Central/South American origin. On unadjusted analysis, only Caribbean-origin Hispanics (prevalence ratio = 1.2; 95% confidence interval [CI]: 1.03 to 1.4) had greater prevalence of hypertension than non-Hispanic whites. Hispanic subgroups were more likely to have LVH than non-Hispanic whites after adjustment for hypertension and other covariates (Caribbean-origin Hispanics = odds ratio [OR]: 1.8, 95% CI: 1.1 to 3.0; Mexican-origin Hispanics = OR: 2.2, 95% CI: 1.4 to 3.3; Central/South Americans = OR: 1.5, 95% CI: 0.7 to 3.1). All Hispanic subgroups also had a higher prevalence of concentric and eccentric hypertrophy compared with non-Hispanic whites (p < 0.001).
Caribbean-origin Hispanics had a higher prevalence of LVH and abnormal LV remodeling compared with non-Hispanic whites. A higher prevalence of LVH and abnormal LV remodeling was also observed among Mexican-origin Hispanics, despite a lower prevalence of hypertension. Differences among Hispanic subgroups regarding LVH and LV remodeling should be taken into account when evaluating cardiovascular risk in this population.
本研究旨在比较 MESA（多民族动脉粥样硬化研究）中西班牙裔亚组与非西班牙裔白人间左心室肥厚（LVH）和左心室（LV）重构模式的流行情况。
西班牙裔是美国最大和增长最快的少数族裔，但尚无关于西班牙裔亚组 LVH 和 LV 几何结构的数据。
对年龄在 45 至 84 岁、无临床心血管疾病的 4309 名男性和女性进行心脏磁共振成像。根据自我报告的祖先，将西班牙裔分为亚组。LVH 定义为参照正常血压、非糖尿病、非肥胖人群中 LV 质量指数的上 95 百分位数，根据 LVH 的存在/不存在以及 LV 质量与 LV 舒张末期容积比的异常/正常，将 LV 重构。
在西班牙裔参与者中，574 人来自墨西哥，329 人来自加勒比海地区，161 人来自中/南美洲。未经调整的分析显示，只有加勒比裔西班牙裔（患病率比=1.2；95%置信区间[CI]：1.03 至 1.4）患高血压的比例高于非西班牙裔白人。在调整高血压和其他混杂因素后，西班牙裔亚组比非西班牙裔白人更易发生 LVH（加勒比裔西班牙裔=优势比[OR]：1.8，95%CI：1.1 至 3.0；墨西哥裔西班牙裔=OR：2.2，95%CI：1.4 至 3.3；中/南美洲裔=OR：1.5，95%CI：0.7 至 3.1）。与非西班牙裔白人相比，所有西班牙裔亚组的向心性和偏心性肥厚的患病率也更高（p<0.001）。
与非西班牙裔白人相比，加勒比裔西班牙裔的 LVH 和异常 LV 重构发生率更高。尽管高血压的患病率较低，但在墨西哥裔西班牙裔中也观察到 LVH 和异常 LV 重构的发生率更高。在评估该人群的心血管风险时，应考虑西班牙裔亚组之间 LVH 和 LV 重构的差异。
