[主动脉根部尺寸与心血管疾病之间的关系]

Ma Wei, Yang Ying, Qi Li-Tong, Zhao Feng, Zhang Bao-Wei, Chen Feng, Wang Shu-Yu, Zhu Sai-Nan, Huo Yong

Department of Cardiology, Peking University First Hospital, Beijing 100034, China.

Zhonghua Xin Xue Guan Bing Za Zhi. 2011 Jun;39(6):543-8.

OBJECTIVE

To analyze the relation among aortic root dimension (ARD) measured by echocardiography, cardiovascular disease risk factors and cardiovascular disease in adult Beijing community population.

METHODS

Echocardiography was performed in 1041 individuals in a suburban community of Beijing from 2004 to 2005. ARD and other echocardiographic parameters including left atria dimension, left ventricular mass, septal and posterior wall thickness and dimension were analyzed. Histories of cardiovascular disease as well as risk factors were obtained. Spearman correlation was used to determine the relation between ARD and other cardiovascular risk factors. Multifactorial logistic regression was used to estimate odds ratios (ORs) and 95% confidence intervals (CIs) of ARD and cardiovascular disease.

RESULTS

Ascending aortic dimension (AAD) and mean root dimension (MRD) were positively associated with age, weight, BMI, systolic and diastolic blood pressure, left atria dimension, left ventricular mass, left ventricular septal and posterior wall thickness, and left ventricular dimension. With the lowest quintile of AAD and MRD as the reference, ORs for the highest quintile of AAD for specific cardiovascular diseases in female were as follows: stroke (OR = 2.20, 95%CI: 1.03 - 4.72, P = 0.04), chronic heart failure (OR = 2.62, 95%CI: 1.49 - 4.61, P = 0.001), total cardiovascular disease (OR = 2.52, 95%CI: 1.51 - 4.21, P < 0.001). ORs of MRD were as follows: chronic heart failure (OR = 2.19, 95%CI: 1.26 - 3.80, P = 0.01), total cardiovascular disease (OR = 2.20, 95%CI: 1.32 - 3.68, P = 0.002). After adjustment for age, BMI, smoking status, TC, hypertension, diabetes mellitus, the ORs were not statistically significant (P > 0.05).

CONCLUSION

ARD was positively associated with several CHD risk factors, but was not independent risk factor for cardiovascular disease. ARD may act as an intermediate risk factor for cardiovascular disease. Combined ARD and traditional cardiovascular disease risk factors might enhance the predict power for cardiovascular disease.

目的

分析经超声心动图测量的主动脉根部内径（ARD）与北京成年社区人群心血管疾病危险因素及心血管疾病之间的关系。

方法

2004年至2005年对北京一个郊区社区的1041名个体进行了超声心动图检查。分析了ARD以及其他超声心动图参数，包括左心房内径、左心室质量、室间隔和后壁厚度及内径。获取了心血管疾病史以及危险因素。采用Spearman相关性分析来确定ARD与其他心血管危险因素之间的关系。采用多因素逻辑回归来估计ARD与心血管疾病的比值比（OR）及95%置信区间（CI）。

结果

升主动脉内径（AAD）和平均根部内径（MRD）与年龄、体重、体重指数、收缩压和舒张压、左心房内径、左心室质量、左心室室间隔和后壁厚度以及左心室内径呈正相关。以AAD和MRD的最低五分位数为参照，女性中AAD最高五分位数对应的特定心血管疾病的OR如下：中风（OR = 2.20，95%CI：1.03 - 4.72，P = 0.04）、慢性心力衰竭（OR = 2.62，95%CI：1.49 - 4.61，P = 0.001）、总心血管疾病（OR = 2.52，95%CI：1.51 - 4.21，P < 0.001）。MRD的OR如下：慢性心力衰竭（OR = 2.19，95%CI：1.26 - 3.80，P = 0.01）、总心血管疾病（OR = 2.20，95%CI：1.32 - 3.68，P = 0.002）。在对年龄、体重指数、吸烟状况、总胆固醇、高血压、糖尿病进行校正后，OR无统计学意义（P > 0.05）。