Möttönen Mikko J, Ukkola Olavi, Lumme Jarmo, Kesäniemi Y Antero, Huikuri Heikki V, Perkiömäki Juha S
Research Unit of Internal Medicine, Medical Research Center Oulu, Oulu University Hospital, University of OuluOulu, Finland.
Front Physiol. 2017 May 26;8:341. doi: 10.3389/fphys.2017.00341. eCollection 2017.
The data on cardiac remodeling outside the scope of myocardial infarction and heart failure are limited. A cohort of middle-aged hypertensive subjects with age- and gender-matched control subjects without hypertension ( = 1,045, aged 51 ± 6 years) were randomly selected for the OPERA study (Oulu Project Elucidating Risk of Atherosclerosis study). The majority of those who were still alive after more than 20 years of follow-up underwent thorough re-examinations. Left ventricular mass index (LVMI) increased significantly from 106.5 ± 27.1 (mean ± SD) to 114.6 ± 29.1 g/m ( < 0.001), the thickness of the left ventricular posterior wall (LVPW) from 10.0 ± 1.8 to 10.6 ± 1.7 mm ( < 0.001), fractional shortening (FS) from 35.0 ± 5.7 to 38.4 ± 7.2 % ( < 0.001), and left atrial diameter (LAD) from 38.8 ± 5.2 to 39.4 ± 6.7 mm ( = 0.028) during the 20-year follow-up. After multivariate adjustments, hypertension treated with antihypertensive medication and male gender predicted a smaller increase in the thickness of LVPW ( = 0.017 to <0.001). Baseline higher fasting plasma insulin level, larger intima media thickness of the carotid artery, greater height and antihypertensive medication ( = 0.046-0.002) predicted a smaller (less favorable) change of FS. The increase of LAD was associated with higher baseline diastolic blood pressure ( = 0.034) and greater height ( = 0.006). Aging from middle age to senescence increases the echocardiographic indexes of LVMI, LVPW thickness, FS and LAD. Several baseline factors are associated with these changes.
关于心肌梗死和心力衰竭范围之外的心脏重塑的数据有限。从一组中年高血压受试者中随机选取1045名年龄和性别匹配的无高血压对照受试者，进行OPERA研究（奥卢动脉粥样硬化风险阐明项目研究）。在超过20年的随访后仍存活的大多数受试者接受了全面复查。在20年随访期间，左心室质量指数（LVMI）从106.5±27.1（均值±标准差）显著增加至114.6±29.1 g/m²（P<0.001），左心室后壁厚度（LVPW）从10.0±1.8增加至10.6±1.7 mm（P<0.001），缩短分数（FS）从35.0±5.7增加至38.4±7.2%（P<0.001），左心房直径（LAD）从38.8±5.2增加至39.4±6.7 mm（P=0.028）。经过多变量调整后，使用抗高血压药物治疗的高血压和男性性别预测LVPW厚度增加较小（P=0.017至P<0.001）。基线空腹血浆胰岛素水平较高、颈动脉内膜中层厚度较大、身高较高和使用抗高血压药物（P=0.046 - 0.002）预测FS变化较小（不太有利）。LAD的增加与较高的基线舒张压（P=0.034）和较高的身高（P=0.006）相关。从中年到老年的衰老会增加LVMI、LVPW厚度、FS和LAD的超声心动图指标。几个基线因素与这些变化相关。
