Abstract：
High blood pressure leads to morphologic changes and functional alterations of the myocardial structure. Transthoracic echocardiography is of great clinical interest to evaluate these alterations, using reference values proposed by the American Society of Echocardiography/European Association of Cardiovascular Imaging, largely based on studies in Caucasian Whites. We aimed to assess the impact of hypertension on echocardiographic parameters in a sub-Saharan African community, using ethnic-specific reference values. This study is part of the TAnve HEalth Study, a population-based prospective cohort study initiated in 2015 in the district of Tanve, Republic of Benin. Hypertension was defined as systolic blood pressure ≥140 mm Hg and/or diastolic blood pressure ≥90 mm Hg and/or currently taking antihypertensive medications. All participants had a transthoracic echocardiography. The patterns of diastolic dysfunction and left ventricular (LV) geometry were defined from 486 subjects in the cohort, free from cardiovascular disease, diabetes, and hypertension. Of all participants, 318 (65% women, median age 48 years) had hypertension. Systolic blood pressure correlated significantly (p <0.0001) with LV mass (r = 0.28), wall thickness (r = 0.25), isovolumic relaxation time (r = 0.27), E/A ratio (r = -0.35), lateral e\' velocity (r= -0.41), and E/E\' ratio (r = 0.39). Ventricular geometry was normal in only 22% of participants with hypertension when using the American Society of Echocardiography/European Association of Cardiovascular Imaging reference values, versus 69% with ethnic-specific reference ranges. The severity of hypertension was associated with ventricular geometry abnormalities. The prevalence of diastolic dysfunction was 14.5% (confidence interval 10.6% to 18.4%), including relaxation impairment (9%) and pseudonormal pattern (6%). Thus, correct assessment of the repercussions of hypertension on LV geometry in Black Africans requires ethnic-specific reference values.
摘要：
高血压导致心肌结构的形态变化和功能改变。经胸超声心动图（TTE）对评估这些改变具有很高的临床兴趣，使用美国超声心动图学会/欧洲心血管成像协会（ASE/EACVI）提出的参考值，主要基于对白种人白人的研究。我们旨在评估高血压对撒哈拉以南非洲社区超声心动图参数的影响，使用特定种族的参考值。这项研究是TAHES的一部分，2015年在Tanve地区发起了一项基于人群的前瞻性队列研究，贝宁共和国。高血压定义为SBP≥140mmHg和/或DBP≥90mmHg和/或目前服用抗高血压药物。所有参与者都有TTE。从队列的486名受试者中定义了舒张功能障碍和左心室（LV）几何结构的模式，没有心血管疾病，糖尿病和高血压。在参与者中，318（65%女性，中位年龄48岁）为高血压。收缩压与左心室质量（r=0.28）显着相关（p<0.0001），壁厚（r=0.25），等容弛豫时间(r=0.27)，E/A比（r=-0.35），横向e'速度(r=-0.41)和E/E'比(r=0.39)。当使用ASE/EACVI参考值时，只有22%的高血压参与者的心室几何形状是正常的，vs.69％具有特定种族的参考范围。高血压的严重程度与心室几何结构异常有关。舒张功能障碍的患病率为14.5%(CI:10.6-18.4%),包括松弛损害(9%)和伪正常模式(6%)。因此，正确评估高血压对非洲黑人LV几何形状的影响需要特定种族的参考值。
