Muiesan M L, Salvetti M, Zulli R, Pasini G F, Bettoni G, Monteduro C, Rizzoni D, Castellano M, Agabiti-Rosei E
Cattedra di Semeiotica e Metodologia Medica, UOP Scienze Mediche, Università di Brescia, Italy.
J Hypertens. 1998 Dec;16(12 Pt 1):1805-12. doi: 10.1097/00004872-199816120-00014.
To evaluate the interrelationships between structural alterations in the carotid arteries and left ventricular geometric patterns in a middle-aged general population.
We studied 223 untreated subjects (106 females, 117 males; aged 48-64 years) living in a small town in Northern Italy (Vobarno, Brescia), using a cross-sectional design. The left ventricular mass index was assessed by echocardiography, while the intima-media thickness and the occurrence of plaque were evaluated by ultrasound. Blood pressure was determined by clinic measurements and by 24 h noninvasive ambulatory blood pressure monitoring.
According to the presence of left ventricular hypertrophy (left ventricular mass index > 50 g/m2.7 in males and > 47 g/m2.7 in females) or concentric left ventricular remodelling (normal left ventricular mass index and relative wall thickness > 0.42), the subjects were divided into four groups: 124 subjects with normal left ventricular geometry, 73 subjects with left ventricular hypertrophy (55 with eccentric and 18 with concentric hypertrophy) and 26 subjects with concentric remodelling. The common carotid intima-media thickness and cross-sectional area were significantly greater in the subjects with concentric left ventricular hypertrophy (analysis of variance, P< 0.05) than in those with normal left ventricular geometry. A significantly higher number of plaques was observed in subjects with concentric and eccentric left ventricular hypertrophy.
In a general population of unselected middle-aged subjects, the presence of concentric left ventricular hypertrophy was associated with an increase in intima-media thickness and with the presence of plaque in the carotid arteries, possibly contributing to the worse prognosis observed in this group of patients.
评估中年普通人群中颈动脉结构改变与左心室几何形态之间的相互关系。
我们采用横断面设计，对居住在意大利北部一个小镇（沃巴诺，布雷西亚）的223名未经治疗的受试者（106名女性，117名男性；年龄48 - 64岁）进行了研究。通过超声心动图评估左心室质量指数，同时通过超声评估内膜中层厚度和斑块的发生情况。通过临床测量和24小时无创动态血压监测来测定血压。
根据是否存在左心室肥厚（男性左心室质量指数>50 g/m².⁷，女性>47 g/m².⁷）或同心性左心室重构（正常左心室质量指数且相对壁厚>0.42），将受试者分为四组：124名左心室几何形态正常的受试者，73名左心室肥厚的受试者（55名离心性肥厚和18名同心性肥厚）以及26名同心性重构的受试者。同心性左心室肥厚受试者的颈总动脉内膜中层厚度和横截面积显著大于左心室几何形态正常的受试者（方差分析，P<0.05）。在同心性和离心性左心室肥厚的受试者中观察到的斑块数量明显更多。
在未经选择的中年普通人群中，同心性左心室肥厚的存在与内膜中层厚度增加以及颈动脉斑块的存在相关，这可能导致该组患者预后较差。
