Schieken R M, Schwartz P F, Goble M M
Medical College of Virginia/Virginia Commonwealth University, Richmond 23298-0026, USA.
Circulation. 1998 May 19;97(19):1901-6. doi: 10.1161/01.cir.97.19.1901.
Increased left ventricular (LV) mass is a predictor of cardiovascular disease in adults. The mechanism(s) for these observations are not fully understood.
We repeatedly studied a biracial sample of children from ages 11 through 17 years. At visits 1 through 5, height, weight, and pubertal stage were determined. Blood pressure and heart rate were measured. M-mode and two-dimensional echocardiograms were performed with a 3.5-MHz transducer with the subject in the supine position. LV mass was calculated. Repeated-measures analysis using a mixed modeling approach was performed for LV mass. At all ages, boys had greater LV mass than girls. For the population as a whole, we found significant tracking correlations for LV mass between each interval of measurement and throughout the entire period of examination. The tracking correlation for the entire sample from visit 1 through visit 5 was r=.41. The LV mass in white children tracked from the youngest to the oldest. Black children tracked similarly from ages 1 to 15 years, but tracking was not significant across the widest interval, visit 1 through visit 5. Racial differences were found in the interactions of systolic blood pressure and heart rate, which magnified the differences in LV mass. During adolescence, LV mass tracks significantly in both black and white children.
Interactive effects such as weight, blood pressure, and heart rate magnify sex and race differences in LV mass.
左心室(LV)质量增加是成人心血管疾病的一个预测指标。这些观察结果的机制尚未完全了解。
我们对11至17岁的不同种族儿童样本进行了多次研究。在第1至5次访视时,测定身高、体重和青春期阶段。测量血压和心率。使用3.5兆赫换能器,让受试者仰卧位进行M型和二维超声心动图检查。计算左心室质量。对左心室质量采用混合建模方法进行重复测量分析。在所有年龄段,男孩的左心室质量均大于女孩。对于总体人群,我们发现在每个测量间隔以及整个检查期间,左心室质量之间存在显著的追踪相关性。从第1次访视到第5次访视,整个样本的追踪相关性为r = 0.41。白人儿童的左心室质量从最年幼到最年长都有追踪关系。黑人儿童在1至15岁时的追踪情况类似,但在最宽的间隔(从第1次访视到第5次访视)中追踪不显著。在收缩压和心率的相互作用中发现了种族差异,这放大了左心室质量的差异。在青春期,黑人儿童和白人儿童的左心室质量均有显著追踪关系。
体重、血压和心率等相互作用会放大左心室质量的性别和种族差异。