Vasan Senthil K, Alex Anoop George, Roy Ambuj, Gowri Mahasampath, Sinha Sikha, Suresh Jenifer, Philip Reesa Susan, Kochumon Jolly, Jaiswal Neetu, Arulappan Geethanjali, Ramakrishnan Lakshmy, Sachdev Harshpal Singh, Tandon Nikhil, Thomas Nihal, Jebasingh Felix, Osmond Clive, Karpe Fredrik, Bhargava Santosh K, Antonisamy Belavendra, Prabhakaran Dorairaj, Fall Caroline H D, Thomson Viji S
MRC Lifecourse Epidemiology Centre, University of Southampton, Southampton, UK.
Oxford Centre for Diabetes, Endocrinology and Metabolism, Radcliffe Department of Medicine, University of Oxford, Oxford, UK.
Front Cardiovasc Med. 2023 Jul 13;10:1055454. doi: 10.3389/fcvm.2023.1055454. eCollection 2023.
Asian Indians are at higher risk of cardiometabolic disease compared to other ethnic groups, and the age of onset is typically younger. Cardiac structure and function are poorly characterized in this ethnic group. In this study, we describe image-acquisition methods and the reproducibility of measurements and detailed echocardiography characteristics in two large Indian population-based cohorts (the New Delhi and Vellore Birth Cohorts) from India.
The IndEcho study captured transthoracic echocardiographic measurements of cardiac structure and function from 2,322 men and women aged 43-50 years. M-mode measurements in the parasternal long axis (PLAX) and 2-dimensional (2D) short axis recordings at the mitral valve, mid-papillary and apical level were recorded. Apical 2D recordings of two- three- and four-chamber (2C, 3C and 4C) views and Doppler images (colour, pulsed and continuous) were recorded in cine-loop format. Left ventricular (LV) mass, LV hypertrophy, and indices of LV systolic and diastolic function were derived.
Echocardiographic measurements showed good/excellent technical reproducibility. Hetero-geneity across sites, sex and rural/urban differences in cardiac structure and function were observed. Overall, this cohort of South Asian Indians had smaller LV mass and normal systolic and diastolic function when compared with published data on other Asian Indians and the West, (LV mass indexed for body surface area: Delhi men: 68 g/m, women 63.9; Vellore men: 65.8, women 61.6) but were within ethnic-specific reference ranges. The higher prevalence of obesity, diabetes and hypertension is reflected by the higher proportion of LV remodelling and lesser hypertrophy.
Our study adds to scarce population-based echocardiographic data for mid-life Asian Indians. Compared to published literature on other ethnic groups, the Asian Indian heart is characterised by smaller cardiac dimensions and normal range systolic and diastolic function on a background of a high prevalence of hypertension, diabetes and cardiac disease at a relatively young age. This data will form the basis for further analyses of lifecourse, metabolic and body composition predictors of cardiac structure and function, and echocardiographic predictors of future mortality.
与其他种族群体相比，亚洲印度人患心脏代谢疾病的风险更高，且发病年龄通常更小。该种族群体的心脏结构和功能特征尚不明确。在本研究中，我们描述了来自印度的两个大型基于人群的队列（新德里和韦洛尔出生队列）中的图像采集方法、测量的可重复性以及详细的超声心动图特征。
IndEcho研究对2322名年龄在43 - 50岁的男性和女性进行了经胸超声心动图检查，测量心脏结构和功能。记录胸骨旁长轴（PLAX）的M型测量值以及二尖瓣、乳头肌中部和心尖水平的二维（2D）短轴记录。以电影环格式记录心尖的两腔、三腔和四腔（2C、3C和4C）视图的二维记录以及多普勒图像（彩色、脉冲和连续）。得出左心室（LV）质量、LV肥厚以及LV收缩和舒张功能指标。
超声心动图测量显示出良好/优异的技术可重复性。观察到各研究地点、性别以及心脏结构和功能方面的城乡差异存在异质性。总体而言，与其他亚洲印度人和西方人的已发表数据相比，这一南亚印度人群体的LV质量较小，收缩和舒张功能正常（以体表面积指数化的LV质量：德里男性为68g/m²，女性为63.9；韦洛尔男性为65.8，女性为61.6），但在种族特异性参考范围内。肥胖、糖尿病和高血压的较高患病率反映在LV重塑比例较高和肥厚程度较低上。
我们的研究增加了关于中年亚洲印度人的稀缺的基于人群的超声心动图数据。与其他种族群体的已发表文献相比，亚洲印度人的心脏特征是心脏尺寸较小，在相对年轻时高血压、糖尿病和心脏病患病率较高的背景下，收缩和舒张功能处于正常范围。这些数据将为进一步分析心脏结构和功能的生命历程、代谢和身体成分预测因素以及未来死亡率的超声心动图预测因素奠定基础。
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