颈动脉内中膜厚度与亚临床左心室收缩功能的关系—丹阳研究
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1.南京中医药大学附属医院(江苏省中医院)心血管内科;2.南京中医药大学附属医院(江苏省中医院)高血压研究所;3.南京中医药大学附属医院(江苏省中医院)功能检查科;4.南京中医药大学附属医院(江苏省中医院)超声医学科;5.南京中医药大学附属医院(江苏省中医院)心血管内科、高血压研究所

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江苏省重点研发计划社会发展项目——基于脂质组学评价养心舒脉颗粒治疗慢性稳定型心绞痛疗效的多中心临床研究(BE2021752);江苏省中医高血压病临床医学创新中心重点项目——“以中医表型客观化为特色的高血压流行病学研究”(k2021j17-4);江苏省中医院高峰人才项目——“高血压中西医结合流行病学研究”(y2021rc15)


Association between Carotid Intima-media Thickness and Subclinical Left Ventricular Systolic Function—Danyang Study
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Department of Cardiology, Affiliated Hospital of Nanjing University of Chinese Medicine, Jiangsu Provincial Hospital of Chinese Medicine

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    摘要:

    目的 在丹阳社区人群中探讨颈动脉内中膜厚度(Carotid intima-media thickness, cIMT)与亚临床左心室功能的关系。方法 研究对象为2021年在江苏省丹阳市车站社区招募的受试者。使用GE Vivid E90超声仪测量分析cIMT;二维斑点追踪技术采集左心室整体纵向应变(Global longitudinal strain, GLS)作为评估亚临床收缩功能的指标,二尖瓣口血流频谱和组织多普勒成像采集e’和E/e’比值作为评估亚临床舒张功能的指标。 结果 研究共计纳入561例参与者,平均年龄58.2±11.7岁,其中女性339例(60.4%)。首先使用三分位法将cIMT作为分类变量分析,在单因素分析中,除了左心室射血分数外,GLS(20.5%,20.2%和19.8%),E/A比值(1.13,0.92和0.79)和e’(10.0,8.6和7.6 cm/s)均随着cIMT三分位数从低到高下降,而E/e’比值(7.5,8.2和8.9)随着cIMT三分位数从低到高增加(均Ptrend ≤ 0.002)。然而,进一步进行多因素校正分析后,只有GLS仍随着cIMT三分位数从低到高下降(P < 0.05)。我们进一步将cIMT自然对数转换后进行连续变量分析,结果与分类变量分析类似,仅有GLS与cIMT显著负相关(r = -0.09; P = 0.04);并且在回归分析中也发现了类似的结果(β = -1.12; P = 0.04)。 结论 在江苏丹阳社区人群中,cIMT增厚与GLS减低独立相关。

    Abstract:

    Aim To explore the relationship between carotid intima-media thickness (cIMT) and subclinical left ventricular function in population of Danyang community. Methods The study subjects were recruited in the Station Community of Danyang City, Jiangsu Province in 2021. The carotid intima-media thickness (cIMT) was analyzed and measured by GE Vivid E90 ultrasound instrument. 2D speckle tracking, mitral flow spectrum and tissue Doppler imaging collected global longitudinal strain (GLS), as indicator of subclinical systolic function, and e’ as well as E/ e’ ratio, as markers of subclinical diastolic function, respectively. Results A total of 561 participants (mean age = 58.2 ± 11.7 years) were enrolled, including 339 females (60.4%). cIMT was analyzed as a categorical variable using the tertile method. In simple categorical analyses, GLS (20.5%, 20.2% and 19.8%),E/A ratio (1.13, 0.92 and 0.79) and e’ (10.0, 8.6 and 7.6 cm/s) all decreased from tertiles 1 to 3 of cIMT, while E/e’ ratio (7.5, 8.2 and 8.9) increased from tertiles 1 to 3 of cIMT (P ≤ 0.002) except for left ventricular ejection fraction (P = 0.207). However, after further adjusting for confounding factors, only GLS significantly decreased across tertile of cIMT groups (P < 0.05). Further analysis was conducted using Logarithmic transforming cIMT as a continuous variable, and the results were similar to those of the categorical variable analysis, significantly negative association were only observed between GLS and natural log-transformed cIMT (β = -1.12; P = 0.04). Conclusion In community-dwelled population in Danyang County, increased cIMT is independently correlated with decreased GLS.

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  • 收稿日期:2023-11-27
  • 最后修改日期:2024-01-11
  • 录用日期:2024-03-19
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