Left ventricular and atrial remodelling in hypertensive patients using thresholds from international guidelines and EMINCA data

Sheng, Yuanyuan1,2,3,4; Li, Mengmeng1,2; Xu, Mingjun1,2; Zhang, Yu1,2; Xu, Jinfeng3,4; Huang, Yuxiang3,4; Li, Xiaoyi1,2; Yao, Guihua1,2; Sui, Wenhai1,2; Zhang, Meng1,2; Zhang, Yuan5,6; Zhang, Cheng1,2,7; Zhang, Yun1,2; Zhang, Mei1,2

2022-01-24

10.1093/ehjci/jeab216

European Heart Journal-Cardiovascular Imaging   影响因子和分区

2047-2404

2047-2412

Aims To investigate differences in the prevalence of left ventricular (LV) and left atrial (LA) remodelling in hypertensive patients using various thresholds defined by international guidelines and data from the Echocardiographic Measurements in Normal Chinese Adults (EMINCA) study and different indexation methods. Methods and results LV mass (LVM), relative ventricular wall thickness, and LA volume (LAV) were measured using 2D echocardiography in 612 healthy volunteers selected from the EMINCA study population and 306 adult Chinese patients with hypertension who were age- and gender-matched using propensity score-matched analysis. LVM and LAV values were indexed to body surface area (BSA), height(2)(.)(7), height(1)(.)(7), and height(2) recommended by guidelines or investigators. Using a previously reported method, LV geometry was divided into normal geometry, concentric remodelling, eccentric hypertrophy, and concentric hypertrophy. The prevalence of LV hypertrophy (LVH) and LV geometric patterns in hypertensive patients were compared using different thresholds and indexation methods. Echocardiographic thresholds from guidelines and healthy volunteers exhibited notable differences, particularly for LAV indexed to height(2) and for LVM indexed to height(1.7), which resulted in a significantly lower prevalence of LA dilatation and LVH in healthy volunteers. The total proportion of abnormal LV geometric patterns was significantly lower with thresholds from healthy volunteers than from guidelines when LVM was indexed to BSA, height(1.7), and height(2)(,7). Conclusion Using current echocardiographic thresholds and indexing methods recommended by guidelines may lead to significant misdiagnosis of LA dilatation, and abnormal LV geometry in Chinese patients with hypertension, and thresholds based on ethnic-specific normal echocardiographic reference values and an accurate indexing algorithm are warranted.

hypertension left ventricular remodelling left ventricular hypertrophy left atrial dilatation echocardiography

SCI

英语

其他

National Research Program of China[2016YFC1300302] ; Program of Introducing Talents of Discipline to Universities[BP 0719033] ; State Key Program of National Natural Science of China[82030051] ; International Collaboration and Exchange Program of China[81920108003] ; National Natural Science Foundation of China[82030051,81770442,81970373,81770439,81970377,82000411,31770977]

Cardiovascular System & Cardiology ; Radiology, Nuclear Medicine & Medical Imaging

Cardiac & Cardiovascular Systems ; Radiology, Nuclear Medicine & Medical Imaging

WOS:000761463100015

OXFORD UNIV PRESS

Web of Science

1.Shandong Univ, Key Lab Cardiovasc Remodeling & Funct Res, Chinese Minist Educ, Chinese Natl Hlth Commiss, 107 Wenhuaxi Rd, Jinan 250012, Peoples R China
2.Shandong Univ, Qilu Hosp, Chinese Acad Med Sci,Dept Cardiol, Cheeloo Coll Med,State & Shandong Prov Joint Key, 107 Wenhuaxi Rd, Jinan 250012, Peoples R China
3.Jinan Univ, Dept Ultrasound, Shenzhen Peoples Hosp, Clin Med Coll 2, 1017 Dongmen North Rd, Shenzhen 518020, Peoples R China
4.Southern Univ Sci & Technol, Affiliated Hosp 1, 1017 Dongmen North Rd, Shenzhen 518020, Peoples R China
5.Shandong Univ, Dept Clin Epidemiol, Qilu Hosp, 107 Wenhuaxi Rd, Jinan 250012, Peoples R China
6.Shandong Univ, Cheeloo Coll Med, Clin Res Ctr, 44 Wenhuaxi Rd, Jinan 250012, Peoples R China
7.Shandong First Med Univ, Cardiovasc Dis Res Ctr, Cent Hosp, 105 Jiefang Rd, Jinan 250012, Peoples R China

Sheng, Yuanyuan,Li, Mengmeng,Xu, Mingjun,et al. Left ventricular and atrial remodelling in hypertensive patients using thresholds from international guidelines and EMINCA data[J]. European Heart Journal-Cardiovascular Imaging,2022,23(2).

Sheng, Yuanyuan.,Li, Mengmeng.,Xu, Mingjun.,Zhang, Yu.,Xu, Jinfeng.,...&Zhang, Mei.(2022).Left ventricular and atrial remodelling in hypertensive patients using thresholds from international guidelines and EMINCA data.European Heart Journal-Cardiovascular Imaging,23(2).

Sheng, Yuanyuan,et al."Left ventricular and atrial remodelling in hypertensive patients using thresholds from international guidelines and EMINCA data".European Heart Journal-Cardiovascular Imaging 23.2(2022).