Simon Judit, Fung Kenneth, Raisi-Estabragh Zahra, Aung Nay, Khanji Mohammed Y, Zsarnóczay Emese, Merkely Béla, Munroe Patricia B, Harvey Nicholas C, Piechnik Stefan K, Neubauer Stefan, Leeson Paul, Petersen Steffen E, Maurovich-Horvat Pál
MTA-SE Cardiovascular Imaging Research Group, Medical Imaging Centre, Semmelweis University, Üllői út 78, H-1082 Budapest, Hungary.
Heart and Vascular Center, Semmelweis University, Budapest, Hungary, Városmajor u 68, H-1122 Budapest, Hungary.
Eur Heart J Imaging Methods Pract. 2023 Sep 19;1(2):qyad010. doi: 10.1093/ehjimp/qyad010. eCollection 2023 Sep.
Heart failure (HF) is a major health problem and early diagnosis is important. Atherosclerosis is the main cause of HF and carotid intima-media thickness (IMT) is a recognized early measure of atherosclerosis. This study aimed to investigate whether increased carotid IMT is associated with changes in cardiac structure and function in middle-aged participants of the UK Biobank Study without overt cardiovascular disease.
Participants of the UK Biobank who underwent CMR and carotid ultrasound examinations were included in this study. Patients with heart failure, angina, atrial fibrillation, and history of myocardial infarction or stroke were excluded. We used multivariable linear regression models adjusted for age, sex, physical activity, body mass index, body surface area, hypertension, diabetes, smoking, ethnicity, socioeconomic status, alcohol intake, and laboratory parameters. In total, 4301 individuals (61.6 ± 7.5 years, 45.9% male) were included. Multivariable linear regression analyses showed that increasing quartiles of IMT was associated with increased left and right ventricular (LV and RV) and left atrial volumes and greater LV mass. Moreover, increased IMT was related to lower LV end-systolic circumferential strain, torsion, and both left and right atrial ejection fractions (all < 0.05).
Increased IMT showed an independent association over traditional risk factors with enlargement of all four cardiac chambers, decreased function in both atria, greater LV mass, and subclinical LV dysfunction. There may be additional risk stratification that can be derived from the IMT to identify those most likely to have early cardiac structural/functional changes.
心力衰竭（HF）是一个主要的健康问题，早期诊断很重要。动脉粥样硬化是HF的主要原因，而颈动脉内膜中层厚度（IMT）是公认的动脉粥样硬化早期指标。本研究旨在调查在英国生物银行研究中无明显心血管疾病的中年参与者中，颈动脉IMT增加是否与心脏结构和功能的变化相关。
本研究纳入了接受心脏磁共振成像（CMR）和颈动脉超声检查的英国生物银行参与者。排除患有心力衰竭、心绞痛、心房颤动以及有心肌梗死或中风病史的患者。我们使用了多变量线性回归模型，并对年龄、性别、身体活动、体重指数、体表面积、高血压、糖尿病、吸烟、种族、社会经济地位、酒精摄入量和实验室参数进行了调整。总共纳入了4301名个体（61.6±7.5岁，男性占45.9%）。多变量线性回归分析显示，IMT四分位数增加与左、右心室（LV和RV）及左心房容积增加以及更大的LV质量相关。此外，IMT增加与较低的LV收缩末期圆周应变、扭转以及左、右心房射血分数均相关（均P<0.05）。
IMT增加显示出与传统危险因素独立相关，表现为所有四个心腔扩大、双房功能下降、LV质量增加以及亚临床LV功能障碍。可能存在从IMT得出的额外风险分层，以识别那些最有可能发生早期心脏结构/功能变化的人。
