Department of Medicine, Beth Israel Deaconess Medical Center, Harvard Medical School, 330 Brookline Avenue, RW-453, Boston, MA, 02215, USA.
Division of Cardiovascular Disease, University of Mississippi Medical Center, Jackson, MS, USA.
Int J Cardiovasc Imaging. 2024 Aug;40(8):1705-1712. doi: 10.1007/s10554-024-03159-y. Epub 2024 Jun 23.
Cardiovascular disease (CVD) morbidity and mortality are high among black adults. We aimed to study the granular subclinical relations of aortic stiffness and left ventricular (LV) function and remodeling in blacks, in whom limited data are available. In the Jackson Heart Study, 1050 U.S. community-dwelling black adults without CVD underwent 1.5 T cardiovascular magnetic resonance. We assessed regional and global aortic stiffness and LV structure and function, including LV mass indexed to body surface area (LVMI), end-diastolic volume (LVEDV), ejection fraction (EF), and global and regional circumferential strain (Ecc). Phase contrast images of the cross-sectional aorta at the pulmonary artery bifurcation and abdominal aorta bifurcation were acquired to measure pulse wave velocity of the aortic arch (AA-PWV) and thoracic aorta (T-PWV). Results of multivariable-adjusted analyses are presented as SD unit change in LV variables per SD change in PWV variables. Participants were 62% women with mean age of 59 ± 10 years. Higher AA-PWV and T-PWV were associated with greater LVMI: for T-PWV, β = 0.10, 95% CI = 0.03-0.16, p = 0.002. Higher AA-PWV and T-PWV were associated with worse (more positive) Ecc at the LV base (for AA-PWV, β = 0.13, 95% CI = 0.05-0.20, p = 0.0007), but not mid-LV or apex. AA-PWV and T-PWV were not associated with LV mass/LVEDV or EF. In this cross-sectional study of blacks without CVD in the U.S., aortic stiffness is associated with subclinical adverse LV function in basal segments. Future studies may elucidate the temporal relationships of aortic stiffness on the pattern and progression of LV remodeling, dysfunction, and associated prognosis in blacks.
心血管疾病 (CVD) 在黑人群体中的发病率和死亡率较高。我们旨在研究主动脉僵硬度和左心室 (LV) 功能和重构的颗粒亚临床关系,因为在黑人群体中可用的数据有限。在杰克逊心脏研究中,1050 名美国社区居住的无 CVD 的黑人成年人接受了 1.5T 心血管磁共振检查。我们评估了区域性和全球性主动脉僵硬度以及 LV 结构和功能,包括 LV 质量指数化到体表面积 (LVMI)、舒张末期容积 (LVEDV)、射血分数 (EF) 以及全局和区域性周向应变 (Ecc)。通过获取肺动脉分叉处和腹主动脉分叉处的横截面主动脉的相位对比图像,来测量主动脉弓 (AA-PWV) 和胸主动脉 (T-PWV) 的脉搏波速度。多变量调整分析的结果表示为 LV 变量每单位 PWV 变量变化的 SD 单位变化。参与者中 62%为女性,平均年龄为 59±10 岁。较高的 AA-PWV 和 T-PWV 与更大的 LVMI 相关:对于 T-PWV,β=0.10,95%CI=0.03-0.16,p=0.002。较高的 AA-PWV 和 T-PWV 与 LV 基底节段更差(更正向)的 Ecc 相关(对于 AA-PWV,β=0.13,95%CI=0.05-0.20,p=0.0007),但与 LV 中部或心尖部无关。AA-PWV 和 T-PWV 与 LV 质量/LVEDV 或 EF 无关。在这项美国无 CVD 的黑人的横断面研究中,主动脉僵硬度与基底节段亚临床不良 LV 功能相关。未来的研究可能阐明主动脉僵硬度对黑人 LV 重构、功能障碍以及相关预后模式和进展的时间关系。