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新诊断原发性醛固酮增多症患者血管老化与左心室几何结构的关系。

Relationship between vascular ageing and left ventricular geometry in patients with newly diagnosed primary aldosteronism.

机构信息

Department of Cardiology, The Third Xiangya Hospital, Central South University, Changsha, China.

出版信息

Front Endocrinol (Lausanne). 2022 Aug 8;13:961882. doi: 10.3389/fendo.2022.961882. eCollection 2022.

Abstract

BACKGROUND

Changes in left ventricular (LV) geometry are early manifestations of cardiac damage. The relationship between vascular aging and LV geometry has been reported. However, in newly diagnosed primary aldosteronism (PA), with more severe target organ damage than essential hypertension, the relationship between vascular aging and LV geometry has never been described.

METHODS

We conducted a retrospective study among newly diagnosed PA from 1 January 2017 to 30 September 2021 at the Third Xiangya Hospital. The data of vascular aging parameters were collected, including ankle-brachial index (ABI), brachial-ankle pulse wave velocity (baPWV), and carotid intima-media thickness (cIMT). Echocardiography data were collected to assess LV geometry patterns.

RESULTS

A total of 146 patients with newly diagnosed PA were included. The mean age was 44.77 ± 9.79 years, and 46.58% participants were women. Linear regression analysis adjusting all potential confounders showed that cIMT was significantly associated with LV mass index (LVMI) (β=0.164, P=0.028) and baPWV was significantly associated with relative wall thickness (RWT) (β= 0.00005, P=0.025). Multifactorial adjusted logistic regression analysis demonstrated that cIMT was significantly associated with LV hypertrophy (LVH) (OR=7.421, 95%CI: 1.717-815.688, P=0.021) and baPWV was significantly associated with LV concentric geometry (LVCG) (OR=1.003, 95%CI: 1.001-1.006, P=0.017).

CONCLUSION

baPWV was significantly associated with LVCG and cIMT was significantly associated with LVH in newly diagnosed PA. This study provides insights on the importance of baPWV measurement and cIMT measurement in early assessment of cardiac damage in newly diagnosed PA.

摘要

背景

左心室(LV)几何形状的变化是心脏损伤的早期表现。血管老化与 LV 几何形状之间的关系已被报道。然而,在新诊断的原发性醛固酮增多症(PA)中,靶器官损伤比原发性高血压更为严重,血管老化与 LV 几何形状之间的关系从未被描述过。

方法

我们对 2017 年 1 月 1 日至 2021 年 9 月 30 日期间在第三湘雅医院新诊断的 PA 患者进行了回顾性研究。收集了血管老化参数的数据,包括踝臂指数(ABI)、臂踝脉搏波速度(baPWV)和颈动脉内膜中层厚度(cIMT)。收集超声心动图数据来评估 LV 几何形状模式。

结果

共纳入 146 例新诊断的 PA 患者。平均年龄为 44.77±9.79 岁,46.58%的患者为女性。调整所有潜在混杂因素的线性回归分析显示,cIMT 与 LV 质量指数(LVMI)显著相关(β=0.164,P=0.028),baPWV 与相对壁厚度(RWT)显著相关(β=0.00005,P=0.025)。多因素调整的逻辑回归分析表明,cIMT 与 LV 肥厚(LVH)显著相关(OR=7.421,95%CI:1.717-815.688,P=0.021),baPWV 与 LV 向心性几何形状(LVCG)显著相关(OR=1.003,95%CI:1.001-1.006,P=0.017)。

结论

baPWV 与 LVCG 显著相关,cIMT 与新诊断的 PA 中的 LVH 显著相关。这项研究提供了在新诊断的 PA 中早期评估心脏损伤时,baPWV 测量和 cIMT 测量的重要性的见解。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/3a2a/9393336/bde9bc1da915/fendo-13-961882-g001.jpg

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