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自报体重和身高:对左心室肥厚检测的影响。一项意大利多中心研究。

Self-reported weight and height: implications for left ventricular hypertrophy detection. An Italian multi-center study.

机构信息

Department of Clinical Medicine and Prevention, University of Milano-Bicocca, Milano, Italy.

出版信息

Clin Exp Hypertens. 2011;33(3):192-201. doi: 10.3109/10641963.2010.531852. Epub 2011 Mar 30.

Abstract

We examined the difference between self-reported and measured body size values and their impact on detection of left ventricular hypertrophy (LVH) by echocardiographic LV mass indexation. A total of 1963 subjects referred by their practitioners for routine echocardiographic examination to nine outpatient echocardiographic laboratories across Italy were included in the study. Left ventricular hypertrophy was defined according to two gender- specific criteria as: A) Left ventricular mass (LVM) index ≥49 g/h(2.7) in men and ≥45 g/h(2.7) in women; B) LVM index ≥125 g/m(2) in men and ≥110 g/m(2) in women. Prevalence of LVH was calculated by indexing LVM to both self-reported and measured anthropometric values. In the whole population, LVH tended to be underestimated by self-reported values by 5.4% according to criterion A (48.5% vs. 53.9%, p < 0.001) and by 1.2% according to criterion B (29.6% vs. 30.8%, p < 0.01); similar findings were observed in the hypertensive subgroup encompassing one-half of the sample. Underestimation of LVH was more pronounced in older patients than in younger patients: 8.6% vs. 3.2% (p < 0.001) by criterion A, 3.1% vs. 0.1% (p < 0.001) by criterion B, in women than in men (8.6% vs. 3.3% (p < 0.001) by criterion A and 1.8% vs. 0.5% (p < 0.01) by criterion B. In a sample of outpatients attending echocardiographic laboratories, LVH is misclassified when left ventricular mass is normalized to self-reported weight and height. The error is related to the clinical characteristics of patients and is more pronounced when LVM is normalized to height(2.7).

摘要

我们研究了自我报告的身体尺寸值与实际测量值之间的差异,以及它们对通过超声心动图左心室质量指数(LVMI)检测左心室肥厚(LVH)的影响。本研究共纳入了 1963 名因常规超声心动图检查而由意大利九个门诊超声心动图实验室的医生推荐的患者。LVH 根据两种性别特异性标准定义:A) 男性左心室质量(LVM)指数≥49 g/h(2.7),女性≥45 g/h(2.7);B) 男性 LVM 指数≥125 g/m(2),女性≥110 g/m(2)。通过将 LVM 指数除以自我报告和实际的人体测量值来计算 LVH 的患病率。在整个人群中,根据标准 A,自我报告值低估了 5.4%的 LVH(48.5%比 53.9%,p<0.001),根据标准 B 低估了 1.2%(29.6%比 30.8%,p<0.01);在包含一半样本的高血压亚组中也观察到了类似的结果。与年轻患者相比,老年患者的 LVH 低估更为明显:标准 A 为 8.6%比 3.2%(p<0.001),标准 B 为 3.1%比 0.1%(p<0.001);女性比男性更为明显:标准 A 为 8.6%比 3.3%(p<0.001),标准 B 为 1.8%比 0.5%(p<0.01)。在接受超声心动图实验室检查的门诊患者样本中,当左心室质量被标准化为自我报告的体重和身高时,LVH 被错误分类。这种错误与患者的临床特征有关,当 LVM 被标准化为身高的平方时更为明显(2.7)。

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