Department of Cardiology, Guangdong Cardiovascular Institute, Guangdong Provincial People's Hospital, Guangdong Academy of Medical Sciences, No. 106 Zhongshan 2nd Road, Yuexiu District, Guangzhou, 510080, People's Republic of China.
Department of Internal Medicine, Community Health Center of Liaobu Community, Dongguan, 523411, China.
BMC Cardiovasc Disord. 2022 Jun 13;22(1):265. doi: 10.1186/s12872-022-02709-3.
Left ventricular diastolic dysfunction (LVDD) is common in hypertension and is a predictor of increased cardiovascular risk, however the effect of LVDD, detected by new guideline, on major adverse cardiac events (MACE) is unknown in hypertensive patients without known cardiovascular disease. The present study aims to evaluate LVDD in a community hypertension cohort study and assess the effect of LVDD on MACE. we studied 283 asymptomatic nonischemic patients with hypertension who had baseline echocardiogram between 2012 and 2014. Patients were followed for MACE (myocardial infarction, coronary revascularization procedures, heart failure, stroke, all-cause mortality) with mean follow-up of 5.4 years. A Cox proportional hazards model was used to assess the association of LVDD with MACE. At baseline, 35 of the 283 hypertensions were diagnosed with LVDD (12.3%) and 25 patients were women (15.5%). Women had higher frequency of LVDD than men (8%). During follow-up, there were 26.6% patients occurring MACE in the LVDD group at baseline, 9.9% patients occurring MACE in the group with normal diastolic function. In multivariable Cox regression analyses, LVDD was a stronger predictor of MACE (HR: 2.5; 95% CI: 1.20 to 5.25; c- statistics 0.805) than E/e' ratio (HR: 1.13; 95% CI: 1.04 to 1.22). LVDD was strongly associated with MACE in hypertension patients.
左心室舒张功能障碍（LVDD）在高血压中很常见，是心血管风险增加的预测指标，然而，在没有已知心血管疾病的高血压患者中，新指南检测到的 LVDD 对主要不良心脏事件（MACE）的影响尚不清楚。本研究旨在评估社区高血压队列研究中的 LVDD，并评估 LVDD 对 MACE 的影响。我们研究了 283 例无症状非缺血性高血压患者，这些患者在 2012 年至 2014 年期间进行了基线超声心动图检查。患者的 MACE（心肌梗死、冠状动脉血运重建术、心力衰竭、中风、全因死亡率）进行了平均 5.4 年的随访。使用 Cox 比例风险模型评估 LVDD 与 MACE 的相关性。在基线时，283 例高血压中有 35 例被诊断为 LVDD（12.3%），25 例为女性（15.5%）。女性 LVDD 的发生率高于男性（8%）。在随访期间，LVDD 组的基线 MACE 发生率为 26.6%，正常舒张功能组的 MACE 发生率为 9.9%。在多变量 Cox 回归分析中，LVDD 是 MACE 的更强预测因子（HR：2.5；95%CI：1.20 至 5.25；c 统计量 0.805），而 E/e' 比值为（HR：1.13；95%CI：1.04 至 1.22）。LVDD 与高血压患者的 MACE 密切相关。
