颈动脉内中膜厚度与亚临床左心室收缩功能的关系  

Association between carotid intima-media thickness and subclinical left ventricular systolic function

作　　者：李一博 张雪 梁君雅 花木莲 张思奇 高云 陈超 赵熙璇 何姗姗 王新月 周天娜 何安霞 刘鸣 LI Yibo;ZHANG Xue;LIANG Junya;HUA Mulian;ZHANG Siqi;GAO Yun;CHEN Chao;ZHAO Xixuan;HE Shanshan;WANG Xinyue;ZHOU Tianna;HE Anxia;LIU Ming(Department of Cardiology,Affiliated Hospital of Nanjing University of Chinese Medicine(Jiangsu Provincial Hospital of Chinese Medicine),Nanjing 210029,China;Institute of Hypertension,Affiliated Hospital of Nanjing University of Chinese Medicine(Jiangsu Provincial Hospital of Chinese Medicine),Nanjing 210029,China;Department of Echocardiography,Affiliated Hospital of Nanjing University of Chinese Medicine(Jiangsu Provincial Hospital of Chinese Medicine),Nanjing 210029,China;Department of Ultrasonography,Affiliated Hospital of Nanjing University of Chinese Medicine(Jiangsu Provincial Hospital of Chinese Medicine),Nanjing 210029,China)

机构地区：[1]南京中医药大学附属医院(江苏省中医院)心内科,江苏南京210029 [2]南京中医药大学附属医院(江苏省中医院)高血压研究所,江苏南京210029 [3]南京中医药大学附属医院(江苏省中医院)功能检查科,江苏南京210029 [4]南京中医药大学附属医院(江苏省中医院)超声医学科,江苏南京210029

出　　处：《南京医科大学学报（自然科学版）》2024年第4期491-498,510,共9页Journal of Nanjing Medical University(Natural Sciences)

基　　金：江苏省重点研发计划社会发展项目(BE2021752);江苏省中医高血压病临床医学创新中心重点项目(k2021j17-4);江苏省中医院高峰人才项目(y2021rc15)。

摘　　要：目的:在江苏丹阳社区人群中探讨颈动脉内中膜厚度(carotid intima-media thickness,c IMT)与亚临床左心室功能的关系。方法:研究对象为2021年在江苏省丹阳市车站社区招募的受试者。使用GE Vivid E90超声仪测量分析c IMT;二维斑点追踪技术采集左心室整体纵向应变(left ventricular global longitudinal strain,LVGLS)作为评估亚临床收缩功能的指标,二尖瓣口血流频谱和组织多普勒成像采集e’和E/e’比值作为评估亚临床舒张功能的指标。结果:研究共计纳入561例,年龄(58.2±11.7)岁,其中女339例(60.4%)。首先使用三分位法将cIMT作为分类变量分析,在单因素分析中,除了左心室射血分数外,LVGLS,E/A和e’均随着cIMT三分位数从低到高下降,而E/e’比值随着cIMT三分位数从低到高增加(均P_(trend)≤0.002)。然而,进一步进行多因素校正分析后,只有LVGLS仍随着c IMT三分位数从低到高下降(P<0.05)。进一步将c IMT自然对数转换后进行连续变量分析,结果与分类变量分析结果类似,仅有LVGLS与cIMT显著负相关(r=-0.087,P=0.041);并且在回归分析中也发现了类似的结果(β=-1.12,P=0.041)。结论:在江苏丹阳社区人群中,cIMT增厚与GLS减低独立相关。Objective:To explore the relationship between carotid intima-media thickness(cIMT)and subclinical left ventricular function in population of Danyang community.Methods:The study subjects were recruited in 2021 from the Station Community of Danyang City,Jiangsu Province.cIMT was measured and analyzed by GE Vivid E90 ultrasound instrument.Two-dimensional(2D)speckle tracking technology was used to collect left ventricular global longitudinal strain(LVGLS)of the left ventricle as an indicator for assessing subclinical systolic function.The e’and E/e’ratio were obtained from mitral valve blood flow spectra and tissue Doppler imaging,serving as indicators for evaluating subclinical diastolic function.Results:A total of 561 participants with an average age of(58.2±11.7)years were enrolled,among whom 339(60.4%)were females.Using tertiles of cIMT as a categorical variable,in univariate analysis,LVGLS,E/A ratio,and e’decreased as cIMT tertiles increased,while the E/e’ratio increased(all P_(trend)≤0.002),except for left ventricular ejection fraction.However,after further multivariate adjustment,only LVGLS continued to decrease with increasing cIMT tertiles(P<0.05).Continuous variable analysis after natural logarithm transformation of cIMT yielded results similar to categorical variable analysis,with only LVGLS showing a significant negative correlation with cIMT(r=-0.087,P=0.041),and similar findings were observed in regression analysis(β=-1.12,P=0.041).Conclusion:In the Danyang community population in Jiangsu,increased cIMT is independently correlated with decreased GLS.

关 键 词：颈动脉内中膜厚度 亚临床左心室收缩功能 整体纵向应变 左心室舒张功能 

分 类 号：R540.45[医药卫生—心血管疾病] R540.48[医药卫生—内科学]