Left atrial systolic force and cardiovascular outcome - The Strong Heart Study

被引:69
作者
Chinali, M
de Simone, G
Roman, MJ
Bella, JN
Liu, JE
Lee, ET
Best, LG
Howard, BV
Devereux, RB
机构
[1] Cornell Univ, Weill Med Coll, New York Presbyterian Hosp, Dept Med, New York, NY USA
[2] Univ Naples Federico II, Dept Clin & Expt Med, Naples, Italy
[3] Univ Oklahoma, Sch Publ Hlth Sci, Oklahoma City, OK USA
[4] Missouri Breaks Ind Res Inc, Timber Lake, SD USA
[5] MedStar Res Inst, Washington, DC USA
关键词
echocardiography; atrial function; diastole; and prognosis;
D O I
10.1016/j.amjhyper.2005.05.036
中图分类号
R6 [外科学];
学科分类号
1002 ; 100210 ;
摘要
Background: The force needed to fill the left ventricle (LV) in late diastole (left atrial systolic force [LASF]) is abnormal in diseased hearts. The goal of this study was to determine whether LASF adds to prognostic prediction of other markers of preclinical cardiovascular disease in a population with a high prevalence of hypertension and diabetes. Methods: Doppler echocardiography was performed on 2808 participants of the Strong Heart Study (age 59.3 +/- 8.0 years, 62.5% women, 43.0% hypertensive, 46.7% diabetic, and 54.1% obese) without valvular abnormalities or previous cardiovascular events. The LASF was estimated from mitral orifice area and mitral peak A velocity. Results: The LASF was correlated with older age, higher BP, body mass index, creatinine, serum glucose, insulin levels, and heart rate. After controlling for clinical covariates, LASF was independently associated with higher LV dimensions, LV mass, stroke volume, and cardiac output (all P < .01). In Cox regression analysis, greater LASF was associated with a higher rate of CV events (HR = 1.033, 95% Cl = 1.005 to 1.061; P = .021), independently of demographic characteristics, risk factors, LV geometry, and transmittal diastolic pattern. Conclusions: in a population-based sample of middle-aged and elderly adults with a high prevalence of hypertension and diabetes and without prevalent cardiovascular disease, LASF was associated with geometric changes of the heart and with increased rate of combined fatal and nonfatal cardiovascular events.
引用
收藏
页码:1570 / 1576
页数:7
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