背景:尚不清楚胸主动脉容积(TAV)是否对心血管(CV)疾病的预后和风险评估有用。
目的:本研究评估了TAV与CV危险因素的横断面关联,动脉粥样硬化多种族研究中与心血管事件的纵向关联。
方法:前瞻性数据的回顾性队列分析。
方法:1182名参与者(69±9岁,54%女性,37%白种人,18%中国人,31%非洲裔美国人,14%的西班牙裔,60%高血压,和20%的糖尿病患者)没有先前的CV疾病。
■轴向黑血涡轮自旋回波或1.5T扫描仪上的明亮血液稳态自由进动图像。
结果:使用Simpson方法从轴向图像计算出TAV,包括上升拱段和下降段。在MRI时评估传统的CV危险因素。记录9年随访期间的CV结果,并代表卒中的复合结果,中风死亡,冠心病,冠心病死亡,动脉粥样硬化性死亡,CVD死亡。
方法:使用调整身高和体重的多变量线性回归模型来确定TAV和CV危险因素之间的关系(β系数)。Cox回归模型评估了TAV和偶发CV事件的相关性。P值<0.05被认为具有统计学意义。
结果:平均TAV=139±41mL。在多变量回归中,TAV与年龄直接相关(β=1.6),男性(β=23.9),收缩压(β=0.1),和高血压药物使用(β=7.9);与脂质药物使用(β=-5.3)和治疗糖尿病(β=-8.9)成反比。与高加索人相比,华裔美国人有较高的TAV(β=11.4),而非洲裔美国人的TAV较低(β=-7.0)。较高的TAV与CV事件独立相关(HR:1.057/10mL)。
结论:高TAV与CV事件相关,年龄增长,在接受糖尿病和脂质药物治疗的大量多种族人群中,高血压与较低的TAV相关。
方法:2技术效果:阶段2。
BACKGROUND: It is unclear whether thoracic aortic volume (TAV) is useful for cardiovascular (CV) disease prognosis and risk assessment.
OBJECTIVE: This study evaluated cross-sectional associations of TAV with CV risk factors, and longitudinal association with incident CV events in the multiethnic study of atherosclerosis.
METHODS: Retrospective cohort analysis of prospective data.
METHODS: 1182 participants (69 ± 9 years, 54% female, 37% Caucasian, 18% Chinese, 31% African American, 14% Hispanic, 60% hypertensive, and 20% diabetic) without prior CV disease.
UNASSIGNED: Axial black-blood turbo spin echo or bright blood steady-state free precession images on 1.5T scanners.
RESULTS: TAV was calculated using Simpson\'s method from axial images, and included the ascending arch and descending segments. Traditional CV risk factors were assessed at the time of MRI. CV outcomes over a 9-year follow-up period were recorded and represented a composite of stroke, stroke death, coronary heart disease (CHD), CHD death, atherosclerotic death, and CVD death.
METHODS: Multivariable linear regression models adjusted for height and weight were used to determine the relationship (β coefficient) between TAV and CV risk factors. Cox regression models assessed the association of TAV and incident CV events. A P-value of <0.05 was deemed statistically significant.
RESULTS: Mean TAV was = 139 ± 41 mL. In multivariable regression, TAV was directly associated with age (β = 1.6), male gender (β = 23.9), systolic blood pressure (β = 0.1), and hypertension medication use (β = 7.9); and inversely associated with lipid medication use (β = -5.3) and treated diabetes (β = -8.9). Compared to Caucasians, Chinese Americans had higher TAV (β = 11.4), while African Americans had lower TAV (β = -7.0). Higher TAV was independently associated with incident CV events (HR: 1.057 per 10 mL).
CONCLUSIONS: Greater TAV is associated with incident CV events, increased age, and hypertension in a large multiethnic population while treated diabetes and lipid medication use were associated with lower TAV.
METHODS: 2 TECHNICAL EFFICACY: Stage 2.