Kim Yoo Ri, Pyun Wook Bum, Shin Gil Ja
Division of Cardiology, Department of Internal Medicine,University of Ulsan College of Medicine, Asan Medical Center, Seoul, Korea.
J Cardiovasc Ultrasound. 2010 Sep;18(3):86-90. doi: 10.4250/jcu.2010.18.3.86. Epub 2010 Sep 30.
Anemia is associated with worse long term outcomes in heart failure. However, there is little evidence on the effect of low hemoglobin level to the left ventricular (LV) structure and diastolic function in hypertensive patients. This study assessed the relationship of hemoglobin level to LV filling pressure in elderly hypertensive patients.
From January 2005 to January 2009, 200 newly diagnosed hypertensive patients over 50 years old (mean age 60 ± 6 years, 116 women) were analyzed. The clinical parameters and comprehensive echocardiographic data were obtained. The patients with and without anemia were compared.
There were significant differences between the anemic and non-anemic groups in the LV mass index (115.27 ± 34.95 vs. 103.75 ± 28.21 g/m(2)), left atrial (LA) volume index (29.31 ± 10.74 vs. 24.99 ± 7.43 mL/m(2)), and E/E' (11.92 ± 4.34 vs. 9.37 ± 2.51). Chronic renal failure was more prevalent in anemic group. On multivariate logistic analysis, anemia was significantly correlated with high LV filling pressure, reflected by E/E', even after controlling for LV mass index and LA volume index. Furthermore, E/E' was significantly correlated with the hemoglobin level (R(2) = 0.093, p < 0.001).
In newly-diagnosed hypertensive patients over 50 years old, the presence of anemia was significantly associated with elevated LV filling pressure and LV structural changes. And the hemoglobin level was negatively correlated with noninvasively estimated LV filling pressure.
贫血与心力衰竭患者更差的长期预后相关。然而,关于血红蛋白水平对高血压患者左心室(LV)结构和舒张功能影响的证据很少。本研究评估了老年高血压患者血红蛋白水平与左心室充盈压之间的关系。
分析2005年1月至2009年1月期间200例新诊断的50岁以上高血压患者(平均年龄60±6岁,女性116例)。获取临床参数和全面的超声心动图数据。比较有无贫血的患者。
贫血组和非贫血组在左心室质量指数(115.27±34.95 vs. 103.75±28.21 g/m²)、左心房(LA)容积指数(29.31±10.74 vs. 24.99±7.43 mL/m²)和E/E'(11.92±4.34 vs. 9.37±2.51)方面存在显著差异。慢性肾衰竭在贫血组中更为普遍。多因素逻辑回归分析显示,即使在控制左心室质量指数和左心房容积指数后,贫血仍与以E/E'反映的高左心室充盈压显著相关。此外,E/E'与血红蛋白水平显著相关(R² = 0.093,p < 0.001)。
在新诊断的50岁以上高血压患者中,贫血的存在与左心室充盈压升高和左心室结构改变显著相关。血红蛋白水平与无创估计的左心室充盈压呈负相关。