Left ventricular and atrial remodelling in hypertensive patients using thresholds from international guidelines and EMINCA data
Aims
To investigate differences in the prevalence of left ventricular (LV) and left atrial (LA) remodelling in hypertensive patients using various thresholds defined by international guidelines and data from the Echocardiographic Measurements in Normal Chinese Adults (EMINCA) study and different indexation methods.
Methods and results
LV mass (LVM), relative ventricular wall thickness, and LA volume (LAV) were measured using 2D echocardiography in 612 healthy volunteers selected from the EMINCA study population and 306 adult Chinese patients with hypertension who were age- and gender-matched using propensity score-matched analysis. LVM and LAV values were indexed to body surface area (BSA), height2.7, height1.7, and height2 recommended by guidelines or investigators. Using a previously reported method, LV geometry was divided into normal geometry, concentric remodelling, eccentric hypertrophy, and concentric hypertrophy. The prevalence of LV hypertrophy (LVH) and LV geometric patterns in hypertensive patients were compared using different thresholds and indexation methods. Echocardiographic thresholds from guidelines and healthy volunteers exhibited notable differences, particularly for LAV indexed to height2 and for LVM indexed to height1.7, which resulted in a significantly lower prevalence of LA dilatation and LVH in healthy volunteers. The total proportion of abnormal LV geometric patterns was significantly lower with thresholds from healthy volunteers than from guidelines when LVM was indexed to BSA, height1.7, and height2,7.
Conclusion
Using current echocardiographic thresholds and indexing methods recommended by guidelines may lead to significant misdiagnosis of LA dilatation, and abnormal LV geometry in Chinese patients with hypertension, and thresholds based on ethnic-specific normal echocardiographic reference values and an accurate indexing algorithm are warranted.
Топ-30
Журналы
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Journal of Clinical Hypertension
3 публикации, 12.5%
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Journal of the American Heart Association
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Hypertension Research
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Biomedicines
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Cells
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Journal of Human Hypertension
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European Heart Journal
1 публикация, 4.17%
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Journal of Hypertension
1 публикация, 4.17%
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Frontiers in Pharmacology
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Hypertension
1 публикация, 4.17%
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Clinical Cardiology
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American Journal of Hypertension
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Journal of Geriatric Cardiology
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Journal of Clinical Ultrasound
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Reviews in Cardiovascular Medicine
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Journal of Diabetes Investigation
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Journal of Cardiothoracic Surgery
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Frontiers in Cardiovascular Medicine
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Издатели
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Wiley
6 публикаций, 25%
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Ovid Technologies (Wolters Kluwer Health)
5 публикаций, 20.83%
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Springer Nature
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MDPI
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Oxford University Press
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Frontiers Media S.A.
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Cold Spring Harbor Laboratory
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China Science Publishing & Media
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IMR Press
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