Department of Cardiology, Guangdong Cardiovascular Institute, Guangdong General Hospital, Guangdong Academy of Medical Sciences, The First Affiliated Hospital of South China University of Technology, Guangzhou, China.
Department of Cardiology, Guangdong Cardiovascular Institute, Guangdong Provincial Key Laboratory of Coronary Heart Disease Prevention, Hypertension Research Laboratory, Guangdong General Hospital, Guangdong Academy of Medical Sciences, The First Affiliated Hospital of South China University of Technology, Guangzhou, China.
Clin Exp Hypertens. 2020;42(1):1-7. doi: 10.1080/10641963.2018.1557680. Epub 2019 Jan 30.
: Research hypothesis is that left atrial (LA) volume index is superior to LA diameter index for coronary heart disease and LA volume index is important to refine risk stratification.: We retrospectively enrolled 222 asymptomatic non-ischemic patients with hypertension who had stored digital images in 2012. Patients were followed up for coronary heart disease over a median of 3.2 years. The Area under receiver operating characteristic curve for LA parameters with coronary heart disease was evaluated. Cox regression was used to assess the association between left atrial parameters and coronary heart disease.: The mean age of patients was 62 years, 45% were men, and mean left atrial diameter, mean left atrial volume, mean LA diameter index, mean LA volume index was 32 mm, 43 ml, 21 mm/m2, 27 ml/m2, respectively. After 3.2 years follow up, 10 patients experienced coronary heart disease. Compared with patients without coronary heart disease, LA diameter index and LA volume index increased in coronary heart disease group (P < 0.05). Multivariate cox regression analysis showed, adjusted for age, sex, smoking, cholesterol, fasting plasma glucose, diabetes, systolic blood pressure, left ventricular mass index, and E/e' ratio, a unit rise in LA volume index was associated with a 15% increase in the risk of coronary heart disease. (HR:1.155; 95% CI 1.002-1.332). Compared with LA diameter index, the area under receiver operating characteristic curve values for predicting coronary heart disease were higher for LA volume index (0.797).: Our study showed that LA volume index was superior to LA diameter index. LA volume index had independent prognostic implications in terms of coronary heart disease prediction in hypertension patients with preserved left ventricular ejection fraction.
研究假设是左心房（LA）容积指数优于 LA 直径指数用于冠心病，并且 LA 容积指数对于细化危险分层很重要。我们回顾性地招募了 2012 年有存储数字图像的 222 例无症状非缺血性高血压患者。中位随访 3.2 年，观察这些患者是否患有冠心病。评估 LA 参数与冠心病的受试者工作特征曲线下面积。使用 Cox 回归评估左心房参数与冠心病之间的相关性。患者的平均年龄为 62 岁，45%为男性，平均左心房直径、平均左心房容积、平均 LA 直径指数、平均 LA 容积指数分别为 32mm、43ml、21mm/m2、27ml/m2。随访 3.2 年后，10 例患者发生冠心病。与无冠心病患者相比，冠心病组 LA 直径指数和 LA 容积指数增加（P<0.05）。多变量 Cox 回归分析显示，在校正年龄、性别、吸烟、胆固醇、空腹血糖、糖尿病、收缩压、左心室质量指数和 E/e'比后，LA 容积指数每升高 1 单位，冠心病的风险增加 15%（HR：1.155；95%CI 1.002-1.332）。与 LA 直径指数相比，LA 容积指数预测冠心病的受试者工作特征曲线下面积值更高（0.797）。我们的研究表明，LA 容积指数优于 LA 直径指数。在左心室射血分数正常的高血压患者中，LA 容积指数对冠心病的预测具有独立的预后意义。
