儿童期哮喘病史与无症状青年成人左心室质量：博加卢萨心脏研究
A History of Asthma From Childhood and Left Ventricular Mass in Asymptomatic Young Adults: The Bogalusa Heart Study.
作者信息
Sun Dianjianyi, Wang Tiange, Heianza Yoriko, Lv Jun, Han Liyuan, Rabito Felicia, Kelly Tanika, Li Shengxu, He Jiang, Bazzano Lydia, Chen Wei, Qi Lu
机构信息
Department of Epidemiology, School of Public Health and Tropical Medicine, Tulane University, New Orleans, Louisiana.
Department of Epidemiology, School of Public Health and Tropical Medicine, Tulane University, New Orleans, Louisiana; Shanghai Institute of Endocrine and Metabolic Diseases, Rui Jin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China.
出版信息
JACC Heart Fail. 2017 Jul;5(7):497-504. doi: 10.1016/j.jchf.2017.03.009. Epub 2017 Jun 26.
OBJECTIVES
This study aimed to examine whether a history of asthma from childhood is associated with left ventricular (LV) mass in adulthood.
BACKGROUND
Asthma has been related to various cardiovascular risk factors affecting LV hypertrophy. The authors saw a need for a prospective study to analyze the relationship between a history of asthma from childhood and markers of LV mass among asymptomatic young adults.
METHODS
Prospective analyses were performed among 1,118 Bogalusa Heart Study participants (average age at follow-up 36.7 ± 5.1 years), with a baseline history of self-reported asthma collected since childhood (average age at baseline 26.8 ± 10.1 years). LV mass (g) was assessed using 2-dimensional guided M-mode echocardiography and was indexed for body height (m) as LV mass index (LVMI; g/m). A multivariate linear mixed model was fitted for the repeated measures.
RESULTS
After an average of 10.4 ± 7.5 years of follow-up, participants with a history of asthma from childhood had a greater LV mass (167.6 vs. 156.9; p = 0.01) and LVMI (40.7 vs. 37.7; p < 0.01) with adjustment for age, sex, race, smoking status, antihypertensive medication, heart rate, and systolic blood pressure (SBP). The difference of LVMI between group with asthma and the group without asthma remained significant after additional adjustment for body mass index (39.0 vs. 37.1; p = 0.03) and high-sensitivity C-reactive protein (38.4 vs. 36.6; p = 0.04). In addition, the authors found significant interactions between SBP and asthma on LV mass and LVMI (p for interaction <0.01, respectively). The associations between asthma and LV measures appeared to be stronger among pre-hypertensive and hypertensive participants (SBP ≥130 mm Hg) compared with participants with normal SBP (<130 mm Hg) (regression coefficient: 39.5 vs. 2.3 for LV mass and 9.0 vs. 0.9 for LVMI).
CONCLUSIONS
The findings of this study indicate that a history of asthma is associated with higher LVMI, and this association is stronger among participants with pre-hypertension and hypertension.
目的
本研究旨在探讨儿童期哮喘病史与成年期左心室（LV）质量是否相关。
背景
哮喘与影响左心室肥厚的多种心血管危险因素有关。作者认为有必要进行一项前瞻性研究，以分析儿童期哮喘病史与无症状年轻成年人左心室质量标志物之间的关系。
方法
对1118名博加卢萨心脏研究参与者（随访时平均年龄36.7±5.1岁）进行前瞻性分析，这些参与者自儿童期起就有自我报告的哮喘基线病史（基线时平均年龄26.8±10.1岁）。使用二维引导M型超声心动图评估左心室质量（g），并根据身高（m）计算左心室质量指数（LVMI；g/m）。采用多元线性混合模型对重复测量数据进行拟合。
结果
平均随访10.4±7.5年后，儿童期有哮喘病史的参与者在调整年龄、性别、种族、吸烟状况、抗高血压药物、心率和收缩压（SBP）后，左心室质量（167.6 vs. 156.9；p = 0.01）和左心室质量指数（40.7 vs. 37.7；p < 0.01）更高。在进一步调整体重指数（39.0 vs. 37.1；p = 0.03）和高敏C反应蛋白（38.4 vs. 36.6；p = 0.04）后，哮喘组与非哮喘组之间的左心室质量指数差异仍然显著。此外，作者发现收缩压与哮喘在左心室质量和左心室质量指数上存在显著交互作用（交互作用p值均<0.01）。与收缩压正常（<130 mmHg）的参与者相比，高血压前期和高血压参与者（收缩压≥130 mmHg）中哮喘与左心室测量值之间的关联似乎更强（左心室质量的回归系数：39.5 vs. 2.3；左心室质量指数的回归系数：9.0 vs. 0.9）。
结论
本研究结果表明，哮喘病史与较高的左心室质量指数相关，且这种关联在高血压前期和高血压参与者中更强。
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