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左心室舒张功能的决定因素——芬兰青年人心血管风险研究

Determinants of left ventricular diastolic function-The Cardiovascular Risk in Young Finns Study.

作者信息

Heiskanen Jarkko S, Ruohonen Saku, Rovio Suvi P, Kytö Ville, Kähönen Mika, Lehtimäki Terho, Viikari Jorma S A, Juonala Markus, Laitinen Tomi, Tossavainen Päivi, Jokinen Eero, Hutri-Kähönen Nina, Raitakari Olli T

机构信息

Research Center of Applied and Preventive Cardiovascular Medicine, University of Turku, Turku, Finland.

Orion Pharma, Turku, Finland.

出版信息

Echocardiography. 2019 May;36(5):854-861. doi: 10.1111/echo.14321. Epub 2019 Mar 24.

Abstract

Decreased left ventricular (LV) diastolic function is associated with increased all-cause mortality and risk for a heart failure. The determinants of LV diastolic function have been mainly studied in elderly populations; however, the origin of LV heart failure may relate to the lifestyle factors acquired during the life course. Therefore, we examined biochemical, physiological, and lifestyle determinants of LV diastolic function in 34-49-year-old participants of the Cardiovascular Risk in Young Finns Study (Young Finns Study). In 2011, clinical examination and echocardiography were performed for 1928 participants (880 men and 1048 women; aged 34-49 years). LV diastolic function was primarily defined using E/é-ratio (population mean 4.8, range 2.1-9.0). In a multivariate model, systolic blood pressure (P < 0.005), female sex (P < 0.005), age (P < 0.005), waist circumference (P = 0.024), smoking (P = 0.028), serum alanine aminotransferase (P = 0.032) were directly associated with E/é-ratio, while an inverse association was found for height (P < 0.005). Additionally, a higher E/é-ratio was found in participants with concentric hypertrophy compared to normal cardiac geometry (P < 0.005). Other indicators of the LV diastolic function including E/A-ratio and left atrial volume index showed similarly strong associations with systolic blood pressure and age. In conclusion, we identified systolic blood pressure, waist circumference and smoking as modifiable determinants of the LV diastolic function in the 34-49-year-old participants of the Young Finns Study.

摘要

左心室(LV)舒张功能降低与全因死亡率增加及心力衰竭风险升高相关。LV舒张功能的决定因素主要在老年人群中进行了研究;然而,LV心力衰竭的起源可能与生命历程中获得的生活方式因素有关。因此,我们在芬兰年轻人心血管风险研究(年轻芬兰人研究)34至49岁的参与者中,研究了LV舒张功能的生化、生理和生活方式决定因素。2011年,对1928名参与者(880名男性和1048名女性;年龄34至49岁)进行了临床检查和超声心动图检查。LV舒张功能主要使用E/é比值来定义(总体均值4.8,范围2.1至9.0)。在多变量模型中,收缩压(P<0.005)、女性(P<0.005)、年龄(P<0.005)、腰围(P = 0.024)、吸烟(P = 0.028)、血清丙氨酸转氨酶(P = 0.032)与E/é比值直接相关,而身高与之呈负相关(P<0.005)。此外,与正常心脏结构相比,向心性肥厚参与者的E/é比值更高(P<0.005)。LV舒张功能的其他指标,包括E/A比值和左心房容积指数,与收缩压和年龄也显示出类似的强关联。总之,我们确定收缩压、腰围和吸烟是年轻芬兰人研究中34至49岁参与者LV舒张功能的可改变决定因素。

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