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基层医疗中的左心室重构模式。

Left Ventricular Remodeling Patterns in Primary Healthcare.

机构信息

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.

出版信息

Arq Bras Cardiol. 2020 Jan;114(1):59-65. doi: 10.36660/abc.20180258.


DOI:10.36660/abc.20180258
PMID:32049171
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC7025300/
Abstract

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.

摘要

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。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/4139/7025300/5059ea235e9a/abc-114-01-0059-g01.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/4139/7025300/5059ea235e9a/abc-114-01-0059-g01.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/4139/7025300/5059ea235e9a/abc-114-01-0059-g01.jpg

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Left Ventricular Remodeling Patterns in Primary Healthcare.

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引用本文的文献

[1]
Do We Need to Know the Left Ventricular Geometry Patterns of the Brazilian Population?

Arq Bras Cardiol. 2020-1

本文引用的文献

[1]
The Prevalence of Stages of Heart Failure in Primary Care: A Population-Based Study.

J Card Fail. 2015-11-4

[2]
Age-Related Left Ventricular Changes and Their Association with Leukocyte Telomere Length in Healthy People.

PLoS One. 2015-8-14

[3]
Recommendations for cardiac chamber quantification by echocardiography in adults: an update from the American Society of Echocardiography and the European Association of Cardiovascular Imaging.

Eur Heart J Cardiovasc Imaging. 2015-3

[4]
Left ventricular geometry and all-cause mortality in advanced age.

Heart Lung Circ. 2015-1

[5]
The natural history of left ventricular geometry in the community: clinical correlates and prognostic significance of change in LV geometric pattern.

JACC Cardiovasc Imaging. 2014-9

[6]
Sex-specific cardiovascular structure and function in heart failure with preserved ejection fraction.

Eur J Heart Fail. 2014-2-23

[7]
Longitudinal changes in left ventricular stiffness: a community-based study.

Circ Heart Fail. 2013-6-28

[8]
Urinary albumin excretion at follow-up predicts cardiovascular outcomes in subjects with resistant hypertension.

Am J Hypertens. 2013-6-8

[9]
2013 ACCF/AHA guideline for the management of heart failure: a report of the American College of Cardiology Foundation/American Heart Association Task Force on Practice Guidelines.

J Am Coll Cardiol. 2013-10-15

[10]
Left ventricular remodeling in heart failure: current concepts in clinical significance and assessment.

JACC Cardiovasc Imaging. 2011-1

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