多民族动脉粥样硬化研究中左心室心肌重构的纵向轨迹与心血管危险因素的关联

IF 6.1 1区 医学 Q1 CARDIAC & CARDIOVASCULAR SYSTEMS
Charlène A Mauger, Bharath Ambale-Venkatesh, Avan Suinesiaputra, David A Bluemke, Colin O Wu, Joao A C Lima, Alistair A Young
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引用次数: 0

摘要

背景:了解心血管危险因素对纵向心脏重构的影响,除了质量、体积等标量指标外,还需要对纵向形状变化进行三维分析。本研究的目的是在一项大型队列成像研究中确定心血管危险因素相关重构的轨迹。方法:我们在基线和10年后检查了多种族动脉粥样硬化研究(MESA)的2521名参与者(54%为女性,年龄60±9y)。利用统计形状图谱,通过心脏磁共振成像得出的纵向左心室形状轨迹来评估心肌重构。在调整基线时的性别和年龄后,使用惩罚逻辑回归来检查轨迹评分与心血管危险因素之间的关系。采用多元回归来确定与每个危险因素相关的独立形状变化。结果:在基线和随访期间,高血压患病率(18.4%)、降压药使用率(21.6%)、他汀类药物使用率和已治疗的糖尿病患病率(8.9%)较高;p < 0.05。纵向形状轨迹评分与肥胖、高血压、高血压药物和糖尿病的相关性强于质量和体积变化。结论:利用形状地图集可以检测心血管危险因素相关的纵向重塑轨迹。除了全局变化外,每个危险因素都与心肌的不同区域重构有关。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Longitudinal Trajectories of Left Ventricular Myocardial Remodelling: Associations with Cardiovascular Risk Factors in the Multi-Ethnic Study of Atherosclerosis.

Background: Understanding the influence of cardiovascular risk factors on longitudinal cardiac remodelling requires three-dimensional analysis of longitudinal shape changes beyond scalar indicators such as mass and volumes. The aim of this study is to determine trajectories of cardiovascular risk factor-related remodelling in a large cohort imaging study.

Methods: We examined 2,521 participants (54% female, aged 60±9y) of the Multi-Ethnic Study of Atherosclerosis (MESA) at baseline and after 10 years. Myocardial remodelling was assessed by longitudinal left ventricular shape trajectories derived from cardiac magnetic resonance imaging using a statistical shape atlas. Penalized logistic regression was used to examine the associations between trajectory scores and cardiovascular risk factors, after adjustment for sex and age at baseline. Multivariate regression was used to determine independent shape changes associated with each risk factor.

Results: Between baseline and follow-up, there was a higher prevalence of hypertension (18.4%), antihypertensive medication usage (21.6%), statin usage, and treated diabetes mellitus (8.9%); all p < 0.05. Longitudinal shape trajectory scores had stronger associations with obesity, high blood pressure, hypertension medication and diabetes mellitus, than mass and volume changes (p<0.05). Multivariate regression showed independent longitudinal changes in wall thickening with obesity (13% increase), smoking (11% decrease), and high systolic blood pressure (5.6% increase), with distinct regional variations.

Conclusions: Trajectories of cardiovascular risk factor-related longitudinal remodelling can be examined using shape atlases. In addition to global changes, each risk factor is associated with a distinct regional remodelling of the myocardium.

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来源期刊
CiteScore
10.90
自引率
12.50%
发文量
61
审稿时长
6-12 weeks
期刊介绍: Journal of Cardiovascular Magnetic Resonance (JCMR) publishes high-quality articles on all aspects of basic, translational and clinical research on the design, development, manufacture, and evaluation of cardiovascular magnetic resonance (CMR) methods applied to the cardiovascular system. Topical areas include, but are not limited to: New applications of magnetic resonance to improve the diagnostic strategies, risk stratification, characterization and management of diseases affecting the cardiovascular system. New methods to enhance or accelerate image acquisition and data analysis. Results of multicenter, or larger single-center studies that provide insight into the utility of CMR. Basic biological perceptions derived by CMR methods.
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