Al-Naamani Nadine, Chirinos Julio A, Zamani Payman, Ruthazer Robin, Paulus Jessica K, Roberts Kari E, Barr R Graham, Lima Joao A, Bluemke David A, Kronmal Richard, Kawut Steven M
Department of Medicine, Tufts Medical Center, Boston, MA.
Clinical and Translational Science Institute, Tufts Medical Center, Boston, MA.
J Am Heart Assoc. 2016 Nov 23;5(12):e004162. doi: 10.1161/JAHA.116.004162.
Systemic arterial stiffness is recognized as a major contributor to development of left ventricular dysfunction and failure; however, the relationship of systemic arterial properties and the right ventricle (RV) is unknown.
The associations between systemic arterial measures (total arterial compliance [TAC], systemic vascular resistance [SVR], and aortic augmentation index [AI]) and RV morphology (mass, end-systolic [RVESV] and end-diastolic volume [RVEDV], and ejection fraction [RVEF]) were examined using data from the Multi-Ethnic Study of Atherosclerosis. All analyses were adjusted for anthropometric, demographic, and clinical variables and the corresponding left ventricular parameter. A total of 3842 subjects without clinical cardiovascular disease were included with a mean age of 61 years, 48% male, 39% non-Hispanic white, 25% Chinese-American, 23% Hispanic, and 13% black. RV measures were within normal range for age and sex. A 1-mL/mm Hg decrease in TAC was associated with 3.9-mL smaller RVESV, 7.6-mL smaller RVEDV, and 2.4-g lower RV mass. A 5-Wood-unit increase in SVR was associated with 0.6-mL decrease in RVESV, 1.7-mL decrease in RVEDV, and 0.4-g decrease in RV mass. A 1% increase in AI was associated with 0.2-mL decrease in RVEDV. We found significant effect modification by age, sex, and race for some of these relationships, with males, whites, and younger individuals having greater decreases in RV volumes and mass.
Markers of increased systemic arterial load were associated with smaller RV volumes and lower RV mass in a population of adults without clinical cardiovascular disease.
系统性动脉僵硬度被认为是导致左心室功能障碍和衰竭的主要因素;然而,系统性动脉特性与右心室(RV)之间的关系尚不清楚。
利用动脉粥样硬化多民族研究的数据,研究了系统性动脉指标(总动脉顺应性 [TAC]、全身血管阻力 [SVR] 和主动脉增强指数 [AI])与右心室形态(质量、收缩末期 [RVESV] 和舒张末期容积 [RVEDV] 以及射血分数 [RVEF])之间的关联。所有分析均针对人体测量、人口统计学和临床变量以及相应的左心室参数进行了调整。总共纳入了3842名无临床心血管疾病的受试者,平均年龄为61岁,男性占48%,非西班牙裔白人占39%,华裔美国人占25%,西班牙裔占23%,黑人占13%。右心室测量值在年龄和性别的正常范围内。TAC每降低1 mL/mm Hg与RVESV减小3.9 mL、RVEDV减小7.6 mL以及右心室质量降低2.4 g相关。SVR每增加5 Wood单位与RVESV降低0.6 mL、RVEDV降低1.7 mL以及右心室质量降低0.4 g相关。AI每增加1%与RVEDV降低0.2 mL相关。我们发现其中一些关系存在年龄、性别和种族的显著效应修饰,男性、白人以及较年轻个体的右心室容积和质量下降幅度更大。
在无临床心血管疾病的成年人群中,系统性动脉负荷增加的标志物与较小的右心室容积和较低的右心室质量相关。