主动脉根部内径与心血管疾病的关系

Relation between aortic root dimension and cardiovascular disease

目的 分析北京社区中老年人群主动脉根部内径与心血管疾病危险因素及心血管疾病的关系.方法 2004至2005年在北京首钢地区对1061名居民进行流行病学调查,选取超声心动资料齐全者共1041名进行分析.采用超声心动图测量主动脉根部内径、左心室质量、室间隔和左心室后壁厚度以及左心室大小,同时调查相关心血管危险因素及心血管疾病.采用spearman相关计算主动脉根部内径与其他心血管危险因素的关系.采用多因素logistic回归计算主动脉根部内径与心血管疾病的关系.结果 近端升主动脉内径（AAD）和平均根部内径（MRD）与年龄、体重、体质指数（BMI）、收缩压和舒张压相关（P〈0.01）,还与左心房大小、左心室质量、室间隔及左心室后壁厚度,左心室大小相关（P〈0.01）.以AAD和MRD下四分之一位数为参考,女性AAD上四分之一位数卒中、心力衰竭、总体心血管疾病OR值分别为2.20（95%CI：1.03~4.72,P=0.04）,2.62（95%CI：1.49~4.61,P=0.001）,2.52（95%CI：1.51,4.21,P〈0.001）;MRD上四分之一位数心力衰竭、总体心血管疾病的OR值分别为2.19（95%CI：1.26~3.80,P=0.01）,2.20（95%CI：1.32~3.68,P=0.002）.调整年龄、BMI、吸烟史、总胆固醇、高血压和糖尿病后,上述结果不再具有统计学意义（P〉0.05）.结论 主动脉根部内径相关指标与某些心血管疾病危险因素相关,但不与心血管疾病独立相关,可能是心血管疾病的一个中间指标.联合主动脉根部内径及传统的心血管疾病危险因素或许可以更好地评估心血管疾病.

Objective To analyze the relation among aortic root dimension（ARD） measured by echocardiography, cardiovascular disease risk factors and cardiovascular disease in adult Beijing community population.Methods Echocardiography was performed in 1041 individuals in a suburban community of Beijing from 2004 to 2005. ARD and other echocardiographic parameters including left atria dimension, left ventricular mass, septal and posterior wall thickness and dimension were analyzed. Histories of cardiovascular disease as well as risk factors were obtained. Spearman correlation was used to determine the relation between ARD and other cardiovascular risk factors. Multifactorial logistic regression was used to estimate odds ratios （ORs） and 95% confidence intervals （CIs） of ARD and cardiovascular disease.ResultsAscending aortic dimension （AAD） and mean root dimension（MRD） were positively associated with age, weight, BMI, systolic and diastolic blood pressure, left atria dimension, left ventricular mass, left ventricular septal and posterior wall thickness, and left ventricular dimension. With the lowest quintile of AAD and MRD as the reference, ORs for the highest quintile of AAD for specific cardiovascular diseases in female were as follows： stroke （OR=2.20,95%CI：1.03-4.72,P=0.04）,chronic heart failure （OR=2.62, 95%CI：1.49-4.61,P=0.001）,total cardiovascular disease （OR=2.52, 95%CI：1.51-4.21,P〈0.001）.ORs of MRD were as follows： chronic heart failure （OR=2.19, 95%CI：1.26-3.80,P=0.01）, total cardiovascular disease （OR=2.20, 95%CI：1.32-3.68,P=0.002）. After adjustment for age, BMI, smoking status, TC,hypertension, diabetes mellitus, the ORs were not statistically significant （P〉0.05）.Conclusion ARD was positively associated with several CHD risk factors, but was not independent risk factor for cardiovascular disease. ARD may act as an intermediate risk factor for cardiovascular disease. Combined ARD and traditional cardiovascular disease risk factors might enhance the predict power for cardiovascular disease.