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超声心动图测量的左心室质量与体型、血压及体力活动的关系(弗明汉姆研究)

Association of echocardiographic left ventricular mass with body size, blood pressure and physical activity (the Framingham Study).

作者信息

Savage D D, Levy D, Dannenberg A L, Garrison R J, Castelli W P

机构信息

Framingham Heart Study, National Heart, Lung, and Blood Institute, Massachusetts.

出版信息

Am J Cardiol. 1990 Feb 1;65(5):371-6. doi: 10.1016/0002-9149(90)90304-j.

Abstract

Left ventricular (LV) hypertrophy has been found to predispose to increased cardiovascular morbidity and mortality. To assess the clinical correlates and potential determinants of LV mass, the relation of echocardiographically determined LV mass to a variety of clinical parameters was examined in a general population. From 1979 to 1983 Framingham Heart Study participants underwent routine evaluation including medical history, physical examination and M-mode echocardiography. LV mass was determined using an anatomically validated formula that incorporates measurements of LV wall thickness and LV internal diameter. The study population consisted of 2,226 men and 2,746 women (mean age 51 years, range 17 to 90). Age, height, systolic blood pressure and body mass index (a measure of obesity) were statistically significant and independent correlates of LV mass in both sexes (p less than 0.001). In men under age 50, leisure-time physical activity was associated with LV mass (p less than 0.05), but this was not observed in women. Results from multivariate analyses in which body mass index and subscapular skinfold thickness were included suggest that lean body mass is correlated with LV mass. Maintenance of ideal body weight and normal blood pressure, weight reduction in obese persons and blood pressure control in hypertensive patients may contribute to the primary and secondary prevention of LV hypertrophy and its sequelae. Clinical interpretation of echocardiograms should include consideration of the correlates of LV mass to gain better insight into the pathogenesis of LV hypertrophy.

摘要

左心室(LV)肥厚已被发现易导致心血管疾病发病率和死亡率增加。为了评估左心室质量的临床相关性和潜在决定因素,在普通人群中研究了超声心动图测定的左心室质量与各种临床参数之间的关系。1979年至1983年,弗雷明汉心脏研究参与者接受了包括病史、体格检查和M型超声心动图在内的常规评估。左心室质量使用经过解剖学验证的公式来确定,该公式纳入了左心室壁厚度和左心室内径的测量值。研究人群包括2226名男性和2746名女性(平均年龄51岁,范围17至90岁)。年龄、身高、收缩压和体重指数(肥胖的一种衡量指标)在两性中都是左心室质量的统计学显著且独立的相关因素(p小于0.001)。在50岁以下的男性中,休闲时间的体力活动与左心室质量相关(p小于0.05),但在女性中未观察到这种情况包含体重指数和肩胛下皮褶厚度的多变量分析结果表明,瘦体重与左心室质量相关。维持理想体重和正常血压、肥胖者减重以及高血压患者控制血压可能有助于左心室肥厚及其后遗症的一级和二级预防。超声心动图的临床解读应包括考虑左心室质量的相关因素,以便更好地了解左心室肥厚的发病机制。

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