JAHA:心脏细微变化与血管性脑损伤的关联

2018-12-10 xing.T MedSci原创

在这项大型队列研究的老年参与者中,LV结构和LV收缩功能障碍的亚临床标志与脑梗塞的几率增加和更多的白质高信号相关,与其他血管危险因素无关。这表明终末器官功能障碍在心脏和大脑中同步发生,需要进一步的研究来确定因果关系。

心脏细微变化与大脑结构及其功能之间的关联尚不清楚,一些研究表明亚临床心脏变化可能与血管脑损伤的标志物有关。

近日,血管疾病领域权威杂志JAHA上发表了一篇研究文章,来自ARIC(社区动脉粥样硬化风险)研究(ARIC第5次随访;2011-2013;N=1974)的数据用于探讨心脏结构/功能异常与亚临床脑疾病之间的关系,并评估心脏和血管与大脑变化之间的特定关联所具有的共同机制。

在调整模型中,左心室LV壁厚度每增加1mm,白质高信号高度增加0.66cm3(95%置信区间[CI]为0.08-1.25),LV质量指数每增加10g/cm2,白质高信号高度增加0.64cm3(95%CI为0.19-1.08)。随着LV壁厚度的增加(每1mm的比值比为1.11,95%CI为1.01-1.23)和更大的LV质量(每10g/m2的比值比为1.08,95%CI为1.00-1.17),脑梗塞的几率也增加。较高的射血分数(每变化5%),作为收缩功能的标志,其与梗死的几率降低显著相关(比值比为0.85,95%CI为0.77-0.95),但与皮质梗死无关(比值比为0.92,95%CI为0.78-1.08)。

在这项大型队列研究的老年参与者中,LV结构和LV收缩功能障碍的亚临床标志与脑梗塞的几率增加和更多的白质高信号相关,与其他血管危险因素无关。这表明终末器官功能障碍在心脏和大脑中同步发生,需要进一步的研究来确定因果关系。

原始出处:

Michelle C,et al. Associations of Echocardiography Markers and Vascular Brain Lesions: The ARIC Study.JAHA.2018. https://www.ahajournals.org/doi/10.1161/JAHA.118.008992

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    2018-12-12 zhaohui6731
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    2018-12-12 小小小麦兜

    学习了

    0

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    2018-12-10 天地飞扬

    了解一下,谢谢分享!

    0

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患者女,50岁,因活动后胸闷、气促3年,加重1个月入院。体格检查:心率75次/分,律齐,血压130mmHg/70mmHg,胸骨左缘第3、4肋间可闻及4/6级收缩期吹风样杂音,心尖区可闻及3/6级收缩期杂音,未及心包摩擦音。心电图:窦性心律。术前经胸及术中经食道超声心动图检查:二尖瓣前瓣瓣尖(A2区)左心室侧可见一大小约2.3 cm×2.2 cm 的球形囊性肿块(图1),随心动周期在左心室与左心室流