Bikkina M, Levy D, Evans J C, Larson M G, Benjamin E J, Wolf P A, Castelli W P
Framingham Heart Study, MA 01701.
JAMA. 1994 Jul 6;272(1):33-6.
To evaluate the association of echocardiographically determined left ventricular mass (LVM) with incidence of stroke or transient ischemic attack in an elderly cohort.
Cohort study with a follow-up period of 8 years.
Population-based sample.
Elderly original cohort subjects of the Framingham Heart Study who were free of cerebrovascular disease and atrial fibrillation at the 16th biennial examination and who had adequate echocardiograms. This group consisted of 447 men (mean age, 67.8 years; range, 60 to 90 years) and 783 women (mean age, 69.2 years; range 59 to 90 years).
Age-adjusted 8-year incidence of stroke was examined as a function of baseline quartiles of LVM-to-height ratio. Proportional hazards regression was used in multivariate analyses to assess risk of stroke as a function of LVM-to-height ratio quartile, adjusting for age, sex, systolic blood pressure, hypertension treatment, diabetes, cigarette smoking, and blood lipid levels.
Among the 1230 subjects eligible, 89 cerebrovascular disease events (62 strokes and 27 transient ischemic attacks) occurred during follow-up. In men, 8-year age-adjusted incidence of cerebrovascular events was 18.4% in the highest quartile of LVM-to-height ratio and 5.2% in the lowest quartile. Corresponding values in women were 12.2% and 2.9%. The hazard ratio for cerebrovascular events comparing highest to lowest quartile of LVM-to-height ratio was 2.72 (95% confidence interval [CI], 1.39 to 5.36) after adjusting for age, sex, systolic blood pressure, hypertension treatment, diabetes, cigarette smoking, and the ratio of total cholesterol to high-density lipoprotein cholesterol. After adjusting for age, sex, and cardiovascular disease risk factors, the hazard ratio for cerebrovascular events was 1.45 (95% CI, 1.17 to 1.80) for each quartile increment of LVM-to-height ratio.
Echocardiographically determined LVM-to-height ratio offers prognostic information beyond that provided by traditional cerebrovascular disease risk factors. Echocardiography provides information that facilitates identification of individuals at high risk for stroke and transient ischemic attack.
评估老年队列中经超声心动图测定的左心室质量（LVM）与中风或短暂性脑缺血发作发生率之间的关联。
随访8年的队列研究。
基于人群的样本。
弗雷明汉心脏研究的老年原始队列受试者，在第16次两年一次的检查时无脑血管疾病和房颤，且有足够的超声心动图检查结果。该组包括447名男性（平均年龄67.8岁；范围60至90岁）和783名女性（平均年龄69.2岁；范围59至90岁）。
将年龄调整后的8年中风发生率作为LVM与身高比值基线四分位数的函数进行检查。多变量分析中使用比例风险回归来评估中风风险，作为LVM与身高比值四分位数的函数，并对年龄、性别、收缩压、高血压治疗、糖尿病、吸烟和血脂水平进行调整。
在1230名符合条件的受试者中，随访期间发生了89例脑血管疾病事件（62例中风和27例短暂性脑缺血发作）。在男性中，LVM与身高比值最高四分位数的8年年龄调整后脑血管事件发生率为18.4%，最低四分位数为5.2%。女性的相应值分别为12.2%和2.9%。在对年龄、性别、收缩压、高血压治疗、糖尿病、吸烟以及总胆固醇与高密度脂蛋白胆固醇的比值进行调整后，LVM与身高比值最高四分位数与最低四分位数相比，脑血管事件的风险比为2.72（95%置信区间[CI]，1.39至5.36）。在对年龄、性别和心血管疾病危险因素进行调整后，LVM与身高比值每增加一个四分位数，脑血管事件的风险比为1.45（95%CI，1.17至1.80）。
经超声心动图测定的LVM与身高比值提供了超越传统脑血管疾病危险因素的预后信息。超声心动图提供的信息有助于识别中风和短暂性脑缺血发作的高危个体。
