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Abstract：
To compare the predictive value of mortality between left ventricular hypertrophy (LVH) defined by Chinese thresholds and defined by international guidelines in hypertension individuals and investigate better indexation methods for LVH in Chinese population. We included 2454 community hypertensive patients with Left ventricular mass (LVM) and relative wall thickness. LVM was indexed to body surface area (BSA), height2 7 and height 1 7 . The outcomes were all-cause and cardiovascular mortality. Cox proportional hazards models were used to explore the association between LVH and the outcomes. C-statistics and time-dependent receiver operating characteristic curve (ROC) was used to evaluate the value of those indicators. During a median follow-up of 49 months (interquartile range 2-54 months), 174 participants (7.1%) died from any cause (n = 174), with 71 died of cardiovascular disease. LVM/BSA defined by the Chinese thresholds was significantly associated with cardiovascular mortality (HR: 1.63; 95%CI: 1.00-2.64). LVM/BSA was significantly associated with all-cause mortality using Chinese thresholds (HR: 1.56; 95%CI: 1.14-2.14) and using Guideline thresholds (HR: 1.52; 95%CI: 1.08-2.15). LVM/Height1.7 was significantly associated with all-cause mortality using Chinese thresholds (HR: 1.60; 95%CI: 1.17-2.20) and using Guideline thresholds (HR: 1.54; 95%CI: 1.04-2.27). LVM/Height2.7 was not significantly associated with all-cause mortality. C-statistics indicated that LVM/BSA and LVM/Height1.7 by Chinese thresholds had better predictive ability for mortality. Time-ROC indicated that only LVM/Height1.7 defined by Chinese threshold had incremental value for predicting mortality. We found that in community hypertensive populations, race-specific thresholds should be used to classify LV hypertrophy related to mortality risk stratification. LVM/BSA and LVM/Height1.7 are acceptable normalization method in Chinese hypertension.
摘要：
比较由中国人阈值定义的左心室肥厚（LVH）和由国际指南定义的高血压个体的死亡率预测价值，并探讨更好的中国人群LVH指数化方法。我们纳入了2454例左心室质量（LVM）和相对壁厚的社区高血压患者。LVM以体表面积(BSA)为索引，高度27和高度17。结果是全因死亡率和心血管死亡率。Cox比例风险模型用于探索LVH与结局之间的关联。C统计量和时间依赖性受试者工作特征曲线（ROC）用于评估这些指标的值。在49个月的中位随访期间（四分位数范围2-54个月），174名参与者（7.1%）死于任何原因（n=174），71人死于心血管疾病。由中国阈值定义的LVM/BSA与心血管死亡率显着相关（HR：1.63;95CI：1.00-2.64）。使用中国阈值（HR：1.56;95CI：1.14-2.14）和指南阈值（HR：1.52;95CI：1.08-2.15），LVM/BSA与全因死亡率显着相关。使用中国阈值（HR：1.60;95CI：1.17-2.20）和指南阈值（HR：1.54;95CI：1.04-2.27），LVM/Height1.7与全因死亡率显著相关。LVM/Height2.7与全因死亡率无显著相关性。C统计表明，中国阈值的LVM/BSA和LVM/Height1.7对死亡率具有更好的预测能力。Time-ROC表明，只有中国阈值定义的LVM/Height1.7具有预测死亡率的增量价值。我们发现在社区高血压人群中，应使用种族特异性阈值对与死亡风险分层相关的LV肥大进行分类.LVM/BSA和LVM/Height1.7是中国高血压可接受的归一化方法。
