Hemodynamic function at rest, during acute stress, and in the field - Predictors of cardiac structure and function 2 years later in youth

被引:89
作者
Kapuku, GK
Treiber, FA [1 ]
Davis, HC
Harshfield, GA
Cook, BB
Mensah, GA
机构
[1] Med Coll Georgia, Georgia Prevent Inst, HS-1640, Augusta, GA 30912 USA
[2] Med Coll Georgia, Dept Med, Augusta, GA 30912 USA
[3] Med Coll Georgia, Dept Pediat, Augusta, GA 30912 USA
[4] Med Coll Georgia, Dept Psychiat, Augusta, GA 30912 USA
[5] Med Coll Georgia, Off Biostat, Augusta, GA 30912 USA
关键词
blood pressure; left ventricular mass; ventricular function; youth;
D O I
10.1161/01.HYP.34.5.1026
中图分类号
R6 [外科学];
学科分类号
1002 ; 100210 ;
摘要
Left ventricular hypertrophy is an independent predictor of cardiovascular morbidity and mortality. However, predictors of cardiac structure and function in youth are not completely understood. On 2 occasions (2.3 years apart), we examined 146 youth aged initially 10 to 19 years (mean age, 14.2+/-1.8 years). On the initial visit, hemodynamic function was assessed at rest, during laboratory stress (ie, orthostasis, car-driving simulation, video game, and forehead cold), and in the field (ie, ambulatory blood pressure). Quantitative M-mode echocardiograms were obtained on both visits. On both visits, black compared with white youth had higher resting laboratory systolic blood pressure (P<0.02), greater relative wall thickness (P<0.003), greater left ventricular mass indexed by either body surface area or height(2.7) (P<0.01 for both), and lower midwall fractional shortening ratio (P<0.05). Hierarchical stepwise regression analysis indicated that significant independent predictors of follow-up left ventricular mass/height(2.7) were the initial evaluation of left ventricular mass/height(2.7), body mass index, gender (males more than females), and supine resting total peripheral resistance (final model R-2=0.53). Left ventricular mass/body surface area was predicted by initial left ventricular mass/body surface area, weight, gender, mean supine resting total peripheral resistance, and systolic pressure response to car-driving simulation (final model R-2=0.48). Midwall fractional shortening was predicted by initial midwall fractional shortening, race (white more than black), and lower mean supine total peripheral resistance (final model. R-2=0.13). The clinical significance of these findings and their implications for improved prevention of cardiovascular diseases are yet to be determined.
引用
收藏
页码:1026 / 1031
页数:6
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