Wu Yuzhong, Chen Chen, Wei Fang-Fei, Liang Weihao, Dong Yugang, Liu Chen, Choy Manting, Dong Bin
Department of Cardiology, The First Affiliated Hospital of Sun Yat-Sen University, Guangzhou, 510080, P R China.
NHC Key Laboratory of Assisted Circulation (Sun Yat-sen University), Guangzhou, 510080, P R China.
Hypertens Res. 2024 Feb;47(2):496-506. doi: 10.1038/s41440-023-01475-9. Epub 2023 Oct 19.
The effects of long-term levels of body mass index (BMI), blood pressure (BP), plasma lipids and fasting blood glucose (FBG) on the cardiac structure and function in later life in general population are to evaluate. We included adult participants without heart failure from Framingham Heart Study. The respective averages over a span of 30-36 years of seven parameters were pooled into linear regression models simultaneously to evaluate their associations with subsequent left atrial internal dimension (LAID), left ventricular mass index (LVMi), internal dimension (LVID), ejection fraction (LVEF), global longitudinal strain (GLS) and mitral inflow velocity to early diastolic mitral annular velocity (E/é). In 1838 participants (56.0% female, mean age 66.1 years), per 1-standard deviation (SD) increment of mean BMI correlated with larger LAID and LVID (β 0.05~0.17, standard error [SE] 0.01 for all), greater LVMi (β [SE], 1.49 [0.46]), worse E/é (β [SE], 0.28 [0.05]). Per 1-SD increment of mean systolic BP correlated with greater LVMi (β [SE], 4.70 [0.69]), LVEF (β [SE], 0.73 [0.24]), E/é (β [SE], 0.52 [0.08]), whereas increase of mean diastolic BP correlated with smaller LVMi (β [SE], -1.61 [0.62]), LVEF (β [SE], -0.46 [0.22]), E/é (β [SE], -0.30 [0.07]). Per 1-SD increment of mean high density lipoprotein cholesterol (HDL-c) correlated with smaller LVID (β [SE], -0.03 [0.01]) and better systolic function (LVEF, β [SE], 0.63 [0.19]; GLS, β [SE], -0.20 [0.10]). The variabilities of BMI, BP and HDL-c also correlated with certain cardiac measurements. In long-term, BMI affected the size and mass of heart chambers, systolic and diastolic BP differently influenced left ventricular mass and function, higher HDL-c linked to better systolic function. Clinical trial registration: URL: https://clinicaltrials.gov . Identifier: NCT00005121.
旨在评估一般人群中体重指数（BMI）、血压（BP）、血脂和空腹血糖（FBG）的长期水平对晚年心脏结构和功能的影响。我们纳入了弗雷明汉心脏研究中无心力衰竭的成年参与者。将30至36年期间七个参数各自的平均值同时纳入线性回归模型，以评估它们与随后的左心房内径（LAID）、左心室质量指数（LVMi）、内径（LVID）、射血分数（LVEF）、整体纵向应变（GLS）以及二尖瓣流入速度与二尖瓣环舒张早期速度之比（E/é）的关联。在1838名参与者（女性占56.0%，平均年龄66.1岁）中，平均BMI每增加1个标准差（SD），与更大的LAID和LVID相关（β为0.05至0.17，所有标准误[SE]均为0.01），LVMi更大（β[SE]为1.49[0.46]），E/é更差（β[SE]为0.28[0.05]）。平均收缩压每增加1个SD，与更大的LVMi（β[SE]为4.70[0.69]）、LVEF（β[SE]为0.73[0.24]）、E/é（β[SE]为0.52[0.08]）相关，而平均舒张压升高与更小的LVMi（β[SE]为 -1.61[0.62]）、LVEF（β[SE]为 -0.46[0.22]）、E/é（β[SE]为 -0.30[0.07]）相关。平均高密度脂蛋白胆固醇（HDL-c）每增加1个SD，与更小的LVID相关（β[SE]为 -0.03[0.01]）以及更好的收缩功能相关（LVEF，β[SE]为0.63[0.19]；GLS，β[SE]为 -0.20[0.10]）。BMI、BP和HDL-c的变异性也与某些心脏测量值相关。长期来看，BMI影响心腔大小和质量，收缩压和舒张压对左心室质量和功能有不同影响，较高的HDL-c与更好的收缩功能相关。临床试验注册：网址：https://clinicaltrials.gov 。标识符：NCT00005121。
