Curso de Pós-Graduação em Ciências Cardiovasculares da Universidade Federal Fluminense (UFF), Niterói, RJ - Brazil.
Curso de Pós-Graduação em Ciências Médicas da Universidade Federal Fluminense (UFF), Niterói, RJ - Brazil.
Arq Bras Cardiol. 2020 Jan;114(1):59-65. doi: 10.36660/abc.20180258.
BACKGROUND: Left ventricular remodeling (LVR) is related to both non-fatal and fatal outcomes. OBJECTIVE: To describe the geometric patterns of the LV and their associations. METHODS: A total of 636 individuals between the ages of 45 and 99 years in Rio de Janeiro, Brazil, were submitted to clinical evaluation, laboratory tests, electrocardiogram, and tissue Doppler echocardiography (TDE). The difference between categories was tested with Kruskall-Wallis with post hoc tests, once all variables studied are non-normally distributed and Pearson's Qui-square (categorical variables). Gross and adjusted ORs were estimated by logistic regression. The level of significance was 5% for all tests. Subjects had LVR characterized as: normal geometry (NG), concentric remodeling (CR), concentric hypertrophy (CH), and eccentric hypertrophy (EH). RESULTS: The prevalence of altered patterns was 33%. Subjects presented NG (n = 423; 67%); EH (n = 186; 29%); CH (n = 14; 2%); and CR (n = 13; 2%). The variables of gender, age, level of education and albumin/creatinine ratio (A/C), showed a relationship with the chance of EH even after adjustment. CONCLUSION: Approximately one third of the studied individuals had LVR and were at risk for developing heart failure. Altered A/C in urine was associated with EH, indicating an early relationship between cardiac and renal dysfunction.
背景:左心室重构(LVR)与非致命和致命结局都有关。 目的:描述 LV 的几何形态及其相关性。 方法:在巴西里约热内卢,共有 636 名年龄在 45 岁至 99 岁之间的个体接受了临床评估、实验室检查、心电图和组织多普勒超声心动图(TDE)检查。对于所有研究的变量均呈非正态分布的情况,使用 Kruskal-Wallis 检验进行分类变量的组间比较,并用事后检验进行比较。使用逻辑回归估计总 OR 和调整 OR。所有检验的显著性水平均为 5%。将 LVR 特征描述为:正常几何形态(NG)、向心性重构(CR)、向心性肥厚(CH)和离心性肥厚(EH)。 结果:异常模式的患病率为 33%。研究对象中,NG(n = 423;67%);EH(n = 186;29%);CH(n = 14;2%);和 CR(n = 13;2%)。性别、年龄、教育程度和白蛋白/肌酐比值(A/C)等变量与 EH 的发生几率有关,即使在调整后也是如此。 结论:大约三分之一的研究对象存在 LVR,存在发生心力衰竭的风险。尿液中 A/C 的改变与 EH 有关,表明心脏和肾功能障碍之间存在早期关系。
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