Cumulative Blood Pressure Exposure and Global and Regional Cardiac Structure and Function: The MESA Study.

IF 8.4 2区 医学 Q1 CARDIAC & CARDIOVASCULAR SYSTEMS
Soroush Masrouri, Peyman Tabnak, Parag Chevli, Saeid Mirzai, Leandro Slipczuk, Sujethra Vasu, Joao A C Lima, Michael D Shapiro
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引用次数: 0

Abstract

Aims: This study examined the associations between decade-long cumulative blood pressure (BP) exposure and global/regional myocardial structure and function independent of current BP levels.

Methods: We analyzed 3,015 adults (aged 69.0±9.2 years) from the Multi-Ethnic Study of Atherosclerosis (MESA) who underwent cardiac magnetic resonance (CMR) imaging at year 10 (exam 5, 2010-2012). Measures included left ventricular (LV) parameters, global/regional myocardial function via tagged CMR, interstitial myocardial fibrosis (IMF) via T1-mapping measures (native T1 and extracellular volume fraction [ECV]), and myocardial scar via late gadolinium enhancement (LGE). We used cumulative exposure of BP through baseline and up to exam 5 (millimeters of mercury × year) to represent long-term exposure to BP levels. Linear regression, logistic regression, and generalized additive models were used to quantify the association of cumulative BP parameters with measures of cardiac structure and function.

Results: Higher cumulative systolic BP (SBP), independent of current SBP, correlated with increased LV mass index (1.93 g/m² per SD), worse global/regional circumferential strain (0.24% to 0.38% lower absolute values per SD), and greater myocardial scar risk (OR: 1.36, 95% CI: 1.02-1.82 per SD). Cumulative diastolic BP (DBP) was associated with circumferential strain, showing nearly J-shaped relationships after adjusting for current DBP (all P < 0.05). In non-hypertensive individuals with BP consistently below the hypertension threshold, cumulative SBP remained significantly associated with LV mass index and strain but not myocardial scar (OR: 1.53, 95% CI: 0.82-2.87, P=0.19).

Conclusion: Higher cumulative BP was associated with worse global and regional cardiac structure/function and myocardial scar, independent of a single BP at the time of imaging, and was still observed to some extent in non-hypertensive individuals who consistently maintained blood pressure levels below the hypertension threshold.

累积血压暴露与整体和局部心脏结构和功能:MESA研究。
目的:本研究考察了十年累积血压(BP)暴露与独立于当前血压水平的全球/区域心肌结构和功能之间的关系。方法:我们分析了3015名来自动脉粥样硬化多民族研究(MESA)的成年人(年龄69.0±9.2岁),他们在第10年(2010-2012年第5次检查)接受了心脏磁共振(CMR)成像。测量包括左心室(LV)参数,通过标记CMR的整体/局部心肌功能,通过T1制图测量(原生T1和细胞外体积分数[ECV])的间质性心肌纤维化(IMF),以及通过晚期钆增强(LGE)的心肌疤痕。我们使用基线和检测5(毫米汞×年)的BP累积暴露来表示长期暴露于BP水平。使用线性回归、逻辑回归和广义加性模型来量化累积血压参数与心脏结构和功能测量的关系。结果:累积收缩压(SBP)升高,独立于当前收缩压,与左室质量指数升高(1.93 g/m²/ SD)、整体/区域周向应变加重(每SD绝对值降低0.24%至0.38%)和心肌瘢痕风险升高相关(OR: 1.36, 95% CI: 1.02-1.82 / SD)。累积舒张压(DBP)与周向应变相关,调整当前DBP后呈近似j型关系(均P < 0.05)。在血压持续低于高血压阈值的非高血压个体中,累积收缩压与左室质量指数和应变显著相关,但与心肌疤痕无关(OR: 1.53, 95% CI: 0.82-2.87, P=0.19)。结论:较高的累积血压与较差的整体和局部心脏结构/功能和心肌瘢痕有关,与成像时的单一血压无关,并且在一定程度上仍然存在于持续维持血压低于高血压阈值的非高血压个体中。
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来源期刊
European journal of preventive cardiology
European journal of preventive cardiology CARDIAC & CARDIOVASCULAR SYSTEMS-
CiteScore
12.50
自引率
12.00%
发文量
601
审稿时长
3-8 weeks
期刊介绍: European Journal of Preventive Cardiology (EJPC) is an official journal of the European Society of Cardiology (ESC) and the European Association of Preventive Cardiology (EAPC). The journal covers a wide range of scientific, clinical, and public health disciplines related to cardiovascular disease prevention, risk factor management, cardiovascular rehabilitation, population science and public health, and exercise physiology. The categories covered by the journal include classical risk factors and treatment, lifestyle risk factors, non-modifiable cardiovascular risk factors, cardiovascular conditions, concomitant pathological conditions, sport cardiology, diagnostic tests, care settings, epidemiology, pharmacology and pharmacotherapy, machine learning, and artificial intelligence.
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