PDF(Pubmed)
Abstract：
UNASSIGNED: This study aimed to assess left heart remodelling changes in hypertension, excluding underlying ischaemic heart disease, utilising computed tomography coronary angiography (CTCA) and transthoracic echocardiography (TTE).
UNASSIGNED: A total of 178 patients (mean age 60 ± 9 years, 53% female) were enrolled in the study: Group 1 consisted of patients with essential hypertension (n = 96, Group 1), and Group 2 served as age-matched controls (n = 82, Group 2). All participants underwent both CTCA and TTE. TTE measurements included left ventricle (LV) concentricity and function and left atrial (LA) volume and function. Using both CTCA and TTE, we measured LV diastasis volume (LVdias) and LA diastasis volume (LAdias).
UNASSIGNED: LV mass index and LV mass/height2.7 were similar in both the groups. However, Group 1 had a higher prevalence of concentric LV remodelling, characterised by a larger mean LV wall thickness, increased relative wall thickness ratio, and a reduced ratio of LV end-diastolic volume (LVED) index to mean wall thickness (55 ± 14 vs. 65 ± 15, p = 0.0007). Group 1 showed higher LAdias and LA minimal volumes, while LA reservoir function was lower in Group 2. The LVdias/LAdias ratio was lower in Group 1 compared to Group 2 (TTE 1.77 ± 0.61 vs. 2.24 ± 1.24, p = 0.0025, CTCA 1.50 ± 0.23 vs. 1.69 ± 0.41, p = 0.0002). A composite score based on four combined TTE parameters, namely, LVED index/mean wall thickness ≤57, ratio of early diastolic mitral inflow to mitral annular tissue velocities (E/e\') >8, LVdias/LAdias ≤1.62, and LA reservoir function ≤0.58, yielded the highest discriminatory power (area under the curve-AUC = 0.772) for distinguishing patients with hypertensive heart disease (HHD). Collectively, we refer to these parameters as the LEDA score, with each parameter scored as one point. For LEDA scores of 0, 1, 2, 3, 4, the probability of underlying HHD was 0%, 23%, 59%, 80%, and 95%, respectively. Furthermore, a CTCA-derived LVdias/LAdias ≤1.76, considered as a single parameter, demonstrated modest accuracy in differentiating patients with HHD (AUC = 0.646).
UNASSIGNED: The TTE LEDA score, based on four parameters, namely, LVED index/mean wall thickness, E/e\', LVdias/LAdias, and LA reservoir function, proved to be the most effective in defining left heart remodelling in hypertension.
UNASSIGNED: A total of 178 patients (mean age 60 ± 9 years, 53% female) were enrolled in the study: Group 1 consisted of patients with essential hypertension (n = 96, Group 1), and Group 2 served as age-matched controls (n = 82, Group 2). All participants underwent both CTCA and TTE. TTE measurements included left ventricle (LV) concentricity and function and left atrial (LA) volume and function. Using both CTCA and TTE, we measured LV diastasis volume (LVdias) and LA diastasis volume (LAdias).
UNASSIGNED: LV mass index and LV mass/height2.7 were similar in both the groups. However, Group 1 had a higher prevalence of concentric LV remodelling, characterised by a larger mean LV wall thickness, increased relative wall thickness ratio, and a reduced ratio of LV end-diastolic volume (LVED) index to mean wall thickness (55 ± 14 vs. 65 ± 15, p = 0.0007). Group 1 showed higher LAdias and LA minimal volumes, while LA reservoir function was lower in Group 2. The LVdias/LAdias ratio was lower in Group 1 compared to Group 2 (TTE 1.77 ± 0.61 vs. 2.24 ± 1.24, p = 0.0025, CTCA 1.50 ± 0.23 vs. 1.69 ± 0.41, p = 0.0002). A composite score based on four combined TTE parameters, namely, LVED index/mean wall thickness ≤57, ratio of early diastolic mitral inflow to mitral annular tissue velocities (E/e\') >8, LVdias/LAdias ≤1.62, and LA reservoir function ≤0.58, yielded the highest discriminatory power (area under the curve-AUC = 0.772) for distinguishing patients with hypertensive heart disease (HHD). Collectively, we refer to these parameters as the LEDA score, with each parameter scored as one point. For LEDA scores of 0, 1, 2, 3, 4, the probability of underlying HHD was 0%, 23%, 59%, 80%, and 95%, respectively. Furthermore, a CTCA-derived LVdias/LAdias ≤1.76, considered as a single parameter, demonstrated modest accuracy in differentiating patients with HHD (AUC = 0.646).
UNASSIGNED: The TTE LEDA score, based on four parameters, namely, LVED index/mean wall thickness, E/e\', LVdias/LAdias, and LA reservoir function, proved to be the most effective in defining left heart remodelling in hypertension.
摘要：
■这项研究旨在评估高血压患者的左心重塑变化，排除潜在的缺血性心脏病，利用计算机断层扫描冠状动脉造影（CTCA）和经胸超声心动图（TTE）。
■总共178名患者（平均年龄60±9岁，53％的女性）参加了研究：第1组由原发性高血压患者组成（n=96，第1组），和第2组作为年龄匹配的对照（n=82，第2组）。所有参与者均接受CTCA和TTE。TTE测量包括左心室(LV)同心度和功能以及左心房(LA)容积和功能。同时使用CTCA和TTE，我们测量了左心室舒张容积(LVdias)和LA舒张容积(LAdias).
■两组的LV质量指数和LV质量/高度2.7相似。然而,第1组的同心左心室重塑患病率较高，以较大的平均LV壁厚为特征，增加的相对壁厚比，左心室舒张末期容积（LVED）指数与平均壁厚之比降低（55±14vs.65±15，p=0.0007）。第1组显示出较高的LAdias和最小的LA体积，而LA储层功能在第2组中较低。与第2组相比，第1组的LVdias/LAdias比率较低（TTE1.77±0.61vs.2.24±1.24，p=0.0025，CTCA1.50±0.23vs.1.69±0.41，p=0.0002）。基于四个组合TTE参数的综合得分，即,LVED指数/平均壁厚≤57，舒张早期二尖瓣流入与二尖瓣环组织速度之比（E/e\'）>8，LVdias/LAdias≤1.62，LA储集功能≤0.58，在区分高血压性心脏病（HHD）患者时具有最高的判别力（曲线下面积-AUC=0.772）。总的来说，我们将这些参数称为LEDA得分，每个参数得分为一分。对于LEDA评分为0、1、2、3、4，潜在HHD的概率为0％，23%,59%,80%,95%,分别。此外，CTCA推导的LVdias/LAdias≤1.76，视为单个参数，在区分HHD患者方面表现出适度的准确性（AUC=0.646）。
■TTELEDA得分，基于四个参数，即,LVED指数/平均壁厚，E/E\',LVdias/LAdias,和LA水库功能，被证明是定义高血压患者左心重塑的最有效方法。
■总共178名患者（平均年龄60±9岁，53％的女性）参加了研究：第1组由原发性高血压患者组成（n=96，第1组），和第2组作为年龄匹配的对照（n=82，第2组）。所有参与者均接受CTCA和TTE。TTE测量包括左心室(LV)同心度和功能以及左心房(LA)容积和功能。同时使用CTCA和TTE，我们测量了左心室舒张容积(LVdias)和LA舒张容积(LAdias).
■两组的LV质量指数和LV质量/高度2.7相似。然而,第1组的同心左心室重塑患病率较高，以较大的平均LV壁厚为特征，增加的相对壁厚比，左心室舒张末期容积（LVED）指数与平均壁厚之比降低（55±14vs.65±15，p=0.0007）。第1组显示出较高的LAdias和最小的LA体积，而LA储层功能在第2组中较低。与第2组相比，第1组的LVdias/LAdias比率较低（TTE1.77±0.61vs.2.24±1.24，p=0.0025，CTCA1.50±0.23vs.1.69±0.41，p=0.0002）。基于四个组合TTE参数的综合得分，即,LVED指数/平均壁厚≤57，舒张早期二尖瓣流入与二尖瓣环组织速度之比（E/e\'）>8，LVdias/LAdias≤1.62，LA储集功能≤0.58，在区分高血压性心脏病（HHD）患者时具有最高的判别力（曲线下面积-AUC=0.772）。总的来说，我们将这些参数称为LEDA得分，每个参数得分为一分。对于LEDA评分为0、1、2、3、4，潜在HHD的概率为0％，23%,59%,80%,95%,分别。此外，CTCA推导的LVdias/LAdias≤1.76，视为单个参数，在区分HHD患者方面表现出适度的准确性（AUC=0.646）。
■TTELEDA得分，基于四个参数，即,LVED指数/平均壁厚，E/E\',LVdias/LAdias,和LA水库功能，被证明是定义高血压患者左心重塑的最有效方法。
