高血压患者中脂蛋白(a)与不同主动脉节段扩张之间的关联。
Association Between Lipoprotein(a) and Dilatation of Different Aortic Segments in Hypertensive Patients.
作者信息
Wang Lin, Ma Chaoqun, Liu Xiaowei, Han Wei
机构信息
Department of Cardiology, Zhejiang Hospital, Hangzhou, Zhejiang, China.
The Second College of Clinical Medicine, Zhejiang Chinese Medical University, Hangzhou, Zhejiang, China.
出版信息
Echocardiography. 2025 Jan;42(1):e70061. doi: 10.1111/echo.70061.
PURPOSE
There are limited reports on the potential link between Lp(a) and ARDM. Thus, we examined the relationship between Lp(a) and ARDM among hypertensive patients.
METHODS
We used echocardiography to measure ARDM in 513 consecutively hospitalized patients. namely, the aortic valve annulus (Ava), sinuses of Valsalva (SV), sinotubular junction (STJ), and ascending aorta (AA) in 513 consecutive inpatients. We also examined the Lp(a), and other laboratory profiles of all participants.
RESULTS
Lp(a) exhibited a positive and independent relationship with the SV diameter (coefficient [β] = 0.330, p = 0.002) and STJ (coefficient [β] = 0.253, p = 0.023), regardless of age, sex, height, or other clinical factors among hypertensive, but not nonhypertensive patients. We also demonstrated that a marked rise in Lp(a) levels was independently associated with SV dilatation (SVD) (OR: 1.006, 95% CI: 1.002-1.009, p = 0.002) and AA dilatation (AAD) (OR: 1.006, 95% CI: 1.000-1.011, p = 0.035) in patients with hypertension. In the subgroup analysis, elevated Lp(a) levels were significantly associated with SV dilatation in all subgroups, and with AAD in males and patients aged 65 years or younger (p < 0.05). The restricted cubic spline analysis indicated a linear association between Lp(a) levels and the risk of both SV and AAD (p < 0.05).
CONCLUSIONS
Herein, we were the first to report that among hypertensive patients, elevated Lp(a) concentrations were intricately linked to the ARDMs at SV and STJ. Moreover, we revealed that the Lp(a) level was a stand-alone indicator of SVD and AAD.
目的
关于脂蛋白(a)[Lp(a)]与主动脉根部扩张性疾病(ARDM)之间潜在联系的报道有限。因此,我们研究了高血压患者中Lp(a)与ARDM之间的关系。
方法
我们使用超声心动图对513例连续住院患者的ARDM进行测量,即测量513例连续住院患者的主动脉瓣环(Ava)、主动脉窦(SV)、窦管交界(STJ)和升主动脉(AA)。我们还检测了所有参与者的Lp(a)及其他实验室指标。
结果
无论高血压患者的年龄、性别、身高或其他临床因素如何(非高血压患者则不然),Lp(a)与SV直径(系数[β]=0.330,p=0.002)和STJ(系数[β]=0.253,p=0.023)呈正相关且具有独立性。我们还证明,高血压患者中Lp(a)水平的显著升高与SV扩张(SVD)(比值比:1.006,95%置信区间:1.002 - 1.009,p=0.002)和AA扩张(AAD)(比值比:1.006,95%置信区间:1.000 - 1.011,p=0.035)独立相关。在亚组分析中,Lp(a)水平升高在所有亚组中均与SVD显著相关,在男性和65岁及以下患者中与AAD显著相关(p<0.05)。受限立方样条分析表明Lp(a)水平与SV和AAD风险之间存在线性关联(p<0.05)。
结论
在此,我们首次报道,在高血压患者中,Lp(a)浓度升高与SV和STJ处的ARDM密切相关。此外,我们发现Lp(a)水平是SVD和AAD的独立指标。