Harrap S B, Dominiczak A F, Fraser R, Lever A F, Morton J J, Foy C J, Watt G C
MRC Blood Pressure Unit, Western Infirmary, Glasgow, UK.
Circulation. 1996 Mar 15;93(6):1148-54. doi: 10.1161/01.cir.93.6.1148.
We studied the correlates of left ventricular mass (LVM) in 84 healthy young adults aged 16 to 24 years from the general population. Subjects were selected according to predisposition to hypertension into four groups with either high or low personal blood pressures and either high or low parental blood pressures.
LVM was measured by echocardiography, and measurements of blood pressure, heart rate, body dimensions, and plasma concentrations of components of the renin-angiotensin system were made under resting conditions. LVM was similar in individuals predisposed to hypertension (high personal and parental blood pressures) and those with contrasting predisposition (low personal and parental pressures). Regression analysis of the combined groups showed that LVM correlated closely with body size, particularly lean body mass (r=.69, P<.0001) and systolic (r=.35, P<.0001) but not diastolic blood pressure. Plasma angiotensin II (r=.39, P<.0001), renin (r=.302, P<.01), and angiotensin-converting enzyme (r=.22, P<.05) showed significant correlation with LVM. Multiple regression analysis revealed that plasma angiotensin II was the most important component of the renin-angiotensin system and that its effect was independent of systolic blood pressure and body size.
These findings provide evidence in humans that angiotensin II exerts a direct on myocardial size. This association may have important implications for the complications and treatment of left ventricular hypertrophy.
我们研究了来自普通人群的84名年龄在16至24岁的健康年轻成年人左心室质量(LVM)的相关因素。根据高血压易感性将受试者分为四组,分别具有高或低的个人血压以及高或低的父母血压。
通过超声心动图测量LVM,并在静息状态下测量血压、心率、身体尺寸以及肾素 - 血管紧张素系统各成分的血浆浓度。高血压易感性个体(高个人和父母血压)与具有相反易感性(低个人和父母血压)的个体的LVM相似。对合并组的回归分析表明,LVM与身体大小密切相关,尤其是瘦体重(r = 0.69,P < 0.0001)和收缩压(r = 0.35,P < 0.0001),但与舒张压无关。血浆血管紧张素II(r = 0.39,P < 0.0001)、肾素(r = 0.302,P < 0.01)和血管紧张素转换酶(r = 0.22,P < 0.05)与LVM呈显著相关。多元回归分析显示,血浆血管紧张素II是肾素 - 血管紧张素系统中最重要的成分,其作用独立于收缩压和身体大小。
这些发现为血管紧张素II对心肌大小有直接作用提供了人体证据。这种关联可能对左心室肥厚的并发症和治疗具有重要意义。