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首页> 外文期刊>JACC. Cardiovascular imaging. >Associations of LV hypertrophy with prevalent and incident valve calcification: Multi-ethnic study of atherosclerosis
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Associations of LV hypertrophy with prevalent and incident valve calcification: Multi-ethnic study of atherosclerosis

机译：左室肥厚与普遍性和入射瓣膜钙化的关联：动脉粥样硬化的多民族研究

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The aim of this study was to evaluate the relationship between percentage of predicted left ventricular mass (%PredLVM) and valve calcification in the MESA (Multi-Ethnic Study of Atherosclerosis) study. Cardiac valve calcification has been associated with left ventricular hypertrophy (LVH), which portends cardiovascular events. However, this relationship and its mediators are poorly understood. The MESA study is a longitudinal cohort study of men and women 45 to 84 years of age without clinical cardiovascular disease in whom serial cardiac magnetic resonance and computed tomography imaging were performed. The relationships between baseline %PredLVM and the prevalence, severity, and incidence of aortic valve (AVC) and mitral annulus calcification (MAC) were determined by regression modeling. Prevalent AVC was observed in 630, and MAC was observed in 442 of 5,042 subjects (median 55.9 and 71.1 Agatston units, respectively). After adjustment for age, sex, body mass index (BMI), ethnicity, socioeconomic status, physical activity, diabetes, cholesterol levels, blood pressure, smoking, kidney function, serum lipids, and antihypertensive and statin medications, %PredLVM was associated with prevalent AVC (odds ratio [OR]: 1.18/SD increase in %PredLVM [95% confidence interval (CI): 1.08 to 1.30]; p = 0.0004) and MAC (OR: 1.18 [95% CI: 1.06 to 1.32]; p = 0.002). Similarly, %PredLVM was associated with increased severity of prevalent AVC (risk difference = 0.26 [95% CI: 0.15 to 0.38]; p < 0.0001) and MAC (risk difference = 0.20 [95% CI: 0.03 to 0.37]; p = 0.02). During follow-up (mean 2.4 ± 0.9 years), 153 subjects (4%) developed AVC, and 198 (5%) developed MAC. The %PredLVM was associated with incident AVC (OR: 1.24 [95% CI: 1.04 to 1.47]; p = 0.02) and MAC (OR: 1.18 [95% CI: 1.01 to 1.40]; p = 0.04). Further adjustment for inflammatory markers and coronary artery calcification did not attenuate these associations. Specifically, concentric LVH most strongly predicted incident valve calcification. Within the MESA cohort, LVH was associated with prevalence, severity, and incidence of valve calcification independent of hypertension and other identified confounders.
机译：这项研究的目的是评估MESA（多民族动脉粥样硬化研究）研究中预测的左心室质量百分比（％PredLVM）与瓣膜钙化之间的关系。心脏瓣膜钙化与左心室肥大（LVH）有关，预示着心血管事件。但是，这种关系及其调解者知之甚少。 MESA研究是一项纵向队列研究，研究对象是年龄在45至84岁之间且没有临床心血管疾病的男性和女性，他们进行了连续心脏磁共振和计算机断层扫描成像。通过回归模型确定基线％PredLVM与主动脉瓣（AVC）和二尖瓣环钙化（MAC）的患病率，严重程度和发生率之间的关系。在5,042名受试者中，有630例患了AVC，在442例中观察到了MAC（分别为中位数55.9和71.1 Agatston单位）。在调整了年龄，性别，体重指数（BMI），种族，社会经济地位，身体活动，糖尿病，胆固醇水平，血压，吸烟，肾脏功能，血清脂质以及降压药和他汀类药物后，％PredLVM与流行AVC（赔率[OR]：％PredLVM [95％置信区间（CI）：1.08至1.30]; p = 0.0004; / OR：1.18 [95％CI：1.06至1.32]; p = 0.002）。同样，％PredLVM与流行的AVC（风险差异= 0.26 [95％CI：0.15至0.38]; p <0.0001）和MAC（风险差异= 0.20 [95％CI：0.03至0.37]; p = 0.02）。在随访期间（平均2.4±0.9年），有153名受试者（占4％）发展了AVC，198名受试者（占5％）发展了MAC。 ％PredLVM与事件AVC（OR：1.24 [95％CI：1.04至1.47]; p = 0.02）和MAC（OR：1.18 [95％CI：1.01至1.40]; p = 0.04）相关。炎性标志物和冠状动脉钙化的进一步调整不会减弱这些关联。具体而言，同心LVH最有力地预测了瓣膜钙化。在MESA队列中，LVH与高血压，其他已确定的混杂因素无关，与瓣膜钙化的患病率，严重程度和发生率相关。

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