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首页> 外文期刊>JAMA cardiology. >Right Ventricular Function, Right Ventricular–Pulmonary Artery Coupling, and Heart Failure Risk in 4 US CommunitiesThe Atherosclerosis Risk in Communities (ARIC) Study
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Right Ventricular Function, Right Ventricular–Pulmonary Artery Coupling, and Heart Failure Risk in 4 US CommunitiesThe Atherosclerosis Risk in Communities (ARIC) Study

机译：右心室功能Ventricular-Pulmonary动脉耦合,和心脏4我们CommunitiesThe失败风险在社区动脉粥样硬化风险(ARIC)研究

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Importance? Limited data exist on the prevalence and prognostic importance of right ventricular (RV) dysfunction for heart failure (HF) in the general population.Objective? To assess the prevalence of RV dysfunction and its association with HF and mortality in a community-based elderly cohort.Design, Setting, and Participants? Cross-sectional and time-to-event analysis of participants in the Atherosclerosis Risks in the Community (ARIC), a multicenter, population-based cohort study at the fifth study visit from 2011 to 2013, with a median follow-up of 4.1 years. This study included 1004 elderly participants in the ARIC study attending the fifth study visit who underwent both 3-dimensional and 2-dimensional RV echocardiography. Three-dimensional echocardiography data were analyzed between September 15, 2015, and July 24, 2016.Exposures? Right ventricular ejection fraction (RVEF), RV–pulmonary artery (PA) coupling defined by the RVEF/PA systolic pressure (PASP) ratio, and RV longitudinal strain by 3-dimensional echocardiography.Main Outcomes and Measures? For cross-sectional analysis, the prevalence of RV dysfunction across ACCF/AHA HF stages (0; A, at elevated risk for HF but without structural heart disease or clinical HF; B, structural heart disease but without clinical HF; and C, prevalent HF). For time-to-event analysis, a composite of incident HF hospitalization or all-cause death among participants free of HF at visit 5.Results? Of the 1004 participants, mean (SD) age was 76 (5) years, 385 were men (38%), and 121 were black (12%). Mean (SD) RVEF was 53% (8%). Right ventricular EF, RVEF/PASP, and RV longitudinal strain were each progressively lower across advancing HF stages. Using reference limits from stage 0 participants, RVEF was abnormal in 103 asymptomatic persons with stage A HF (15%) and 27 with stage B HF (24%). Among participants free of HF at baseline, lower RVEF and worse RV-PA coupling (ie, lower RVEF/PASP ratio) both were associated with incident HF or death independent of LVEF and N-terminal pro b-type natriuretic peptide (hazard ratio, 1.20; 95% CI, 1.02-1.42 per 5% decrease in RVEF; P?=?.03; hazard ratio, 1.65, 95% CI, 1.15-2.37 per 0.5 unit decrease in RVEF/PASP ratio; P?=?.007).Conclusions and Relevance? Right ventricular function and RV-PA coupling declined progressively across American College of Cardiology Foundation/American Heart Association HF stages. Among persons free of HF, lower RVEF was associated with incident HF or death independent of LVEF or N-terminal pro b-type natriuretic peptide.
机译：重要吗?右心室和预后的重要性(RV)心力衰竭(HF)的障碍一般population.Objective吗?房车功能障碍的患病率及其协会高频和死亡率在一个社区老年群体。横断面和比较分析参与动脉粥样硬化的风险社区(ARIC),多中心,以人群为基础的队列研究从2011年第五研究访问到2013年,平均4.1年的随访。这项研究包括1004名老年人参与ARIC研究参加第五次访问学习进行了三维和谁二维房车超声心动图。三维超声心动图数据分析之间的2015年9月15日和7月24日2016.曝光?分数(RVEF) RV-pulmonary动脉(PA)定义的耦合RVEF / PA收缩压(PASP)比,和房车纵向应变三维超声心动图。措施?房车功能障碍的患病率在ACCF /啊哈高频阶段(0;结构性心脏病或临床心力衰竭;结构性心脏病但没有临床心力衰竭;高频)和C,普遍。复合事件高频住院或全因死亡参与者自由的高频5.访问结果?(SD)年龄为76岁(5)年,385人(38%),和121是黑人(12%)。(8%)。纵向应变均逐渐降低在高频阶段前进。限制参与者从阶段0,RVEF103年无症状的人阶段异常心力衰竭(15%)和27个阶段B高频(24%)。参与者自由高频的基线,降低RVEF和更糟RV-PA耦合(即低RVEF / PASP)都与事件相关的高频或比例死亡LVEF和n端专业独立的b型利钠肽(风险比,1.20;95%置信区间,1.02 - -1.42在RVEF每下降5%;P = ? .03点;每0.5单元RVEF / PASP比率下降;P = ? .007)。心室功能和RV-PA耦合拒绝了逐步在美国大学心脏病基金会/美国心脏协会高频阶段。与心力衰竭或死亡事件有关独立于LVEF或氨基端b型利钠肽。

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