Cai Anping, Zheng Congyi, Song Qingjie, Qiu Jiayuan, Wang Xin, Hu Zhen, Cao Xue, Tian Yixin, Gu Runqing, Pei Xuyan, Yu Xue, Chang Chenye, Tuerdi Nuerguli, Zhang Yujie, Tian Ye, Feng Yingqing, Wang Zengwu
Department of Cardiology, Hypertension Research Laboratory, Guangdong Cardiovascular Institute, Guangdong Provincial People's Hospital, Guangdong Academy of Medical Sciences Southern Medical University Guangzhou China.
Division of Prevention and Community Health, National Center for Cardiovascular Disease Fuwai Hospital, Peking Union Medical College and Chinese Academy of Medical Sciences Beijing China.
J Am Heart Assoc. 2025 Apr 15;14(8):e038108. doi: 10.1161/JAHA.124.038108. Epub 2025 Apr 10.
Echocardiographic criteria of left ventricular hypertrophy (LVH) recommended in the international guidelines are derived from a White population, which could be less accurate in estimating LVH burden in other ethnic groups. Given that LVH is an important prognostic factor, assessing its burden using ethnically specific criteria has important implications. We sought to evaluate the prevalence and prognostic implications of LVH based on the EMINCA (Echocardiographic Measurements in Normal Chinese Adults) study criteria and the international guidelines.
Nationally representative populations aged ≥35 years (n=20 210; mean age, 56.0 years; 53.3% women) were enrolled from the China Hypertension Survey 2012 to 2015. The EMINCA study criteria for LVH were left ventricular mass index >109 g/m for men and >105 g/m for women; and the international guidelines criteria were left ventricular mass index >115 g/m for men and >95 g/m for women. Prevalence of LVH defined by the EMINCA study and international guidelines was 8.3% (≈56.8 million) and 11.7% (≈80.1 million), respectively. LVH defined by the EMINCA study was associated with adjusted hazard ratio (HR) of 1.55 (95% CI, 1.19-2.01; <0.001) for cardiovascular death and 1.14 (95% CI, 0.95-1.37; =0.16) for all-cause death. LVH defined by the international guidelines was associated with adjusted HR of 1.31 (95% CI, 1.00-1.72; =0.047) for cardiovascular death and 1.12 (95% CI, 0.94-1.34; =0.22) for all-cause death.
LVH diagnosis based on both criteria was independently associated with cardiovascular death. However, the prevalence of LVH in a general Chinese population varies significantly by the echocardiographic criteria.
国际指南中推荐的左心室肥厚（LVH）超声心动图标准源自白人群体，在评估其他种族群体的LVH负担时可能不够准确。鉴于LVH是一个重要的预后因素，使用种族特异性标准评估其负担具有重要意义。我们试图根据EMINCA（中国正常成年人超声心动图测量）研究标准和国际指南评估LVH的患病率及其预后意义。
从2012年至2015年的中国高血压调查中纳入了年龄≥35岁的具有全国代表性的人群（n = 20210；平均年龄56.0岁；女性占53.3%）。EMINCA研究中LVH的标准为男性左心室质量指数>109g/m²，女性>105g/m²；国际指南标准为男性左心室质量指数>115g/m²，女性>95g/m²。根据EMINCA研究和国际指南定义的LVH患病率分别为8.3%（约5680万）和11.7%（约8010万）。根据EMINCA研究定义的LVH与心血管死亡的校正风险比（HR）为1.55（95%CI，1.19 - 2.01；P<0.001），全因死亡的校正HR为1.14（95%CI，0.95 - 1.37；P = 0.16）。根据国际指南定义的LVH与心血管死亡的校正HR为1.31（95%CI，1.00 - 1.72；P = 0.047），全因死亡的校正HR为1.12（95%CI，0.94 - 1.34；P = 0.22）。
基于这两种标准诊断的LVH均与心血管死亡独立相关。然而，中国普通人群中LVH的患病率因超声心动图标准而异。
