左心房功能与虚弱的关系:社区动脉粥样硬化风险(ARIC)研究

IF 4.3 2区 医学 Q1 GERIATRICS & GERONTOLOGY Journal of the American Geriatrics Society Pub Date : 2024-09-13 DOI:10.1111/jgs.19187
Daokun Sun, Romil R. Parikh, Wendy Wang, Anne Eaton, Pamela L. Lutsey, B. Gwen Windham, Riccardo M. Inciardi, Scott D. Solomon, Christie M. Ballantyne, Amil M. Shah, Lin Yee Chen
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引用次数: 0

摘要

背景心血管疾病患者普遍存在心力衰竭问题。左心房(LA)功能较差是心血管疾病的一个独立风险因素。方法我们纳入了社区动脉粥样硬化风险研究(Atherosclerosis Risk in Communities)中的 3292 名老年人,他们在基线(2011-2013 年第 5 次就诊)时并不虚弱,并通过二维斑点追踪超声心动图测量了 LA 功能(储血室、导管和收缩应变)。LA僵化指数按E/e′与LA储层应变的比值计算。虚弱的定义采用经过验证的弗里德虚弱表型。在2016年至2019年期间的两次随访中对发生的虚弱情况进行了评估。LA功能以五分位数进行分析。结果中位数(四分位数间距 [IQR])年龄为 74(71-77)岁,58% 为女性,214(7%)名参与者在中位数(IQR)为 6.3(5.6-6.8)年的随访期间出现虚弱。在对基线混杂因素和随访期间发生的心血管事件进行调整后,LA储层应变最低(与最高)五分位数的参与者发生虚弱的几率是前者的2.42(1.26-4.66)倍,LA僵硬度指数最高(与最低)五分位数的参与者发生虚弱的几率是前者的2.41(1.11-5.22)倍。结论 LA功能较差与虚弱和衰竭的发生率较高有关,与LA大小和左心室功能无关。未来的研究还需要阐明导致这种关联的潜在机制。
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Association of left atrial function with frailty: The Atherosclerosis Risk in Communities (ARIC) study
BackgroundFrailty is common in people with cardiovascular disease. Worse left atrial (LA) function is an independent risk factor for cardiovascular disease. However, whether worse LA function is associated with frailty is unclear.MethodsWe included 3292 older adults from the Atherosclerosis Risk in Communities study who were non‐frail at baseline (visit 5, 2011–2013) and had LA function (reservoir, conduit, and contractile strain) measured from two‐dimensional speckle‐tracking echocardiography. LA stiffness index was calculated as a ratio of E/e′ to LA reservoir strain. Frailty was defined using the validated Fried frailty phenotype. Incident frailty was assessed between 2016 and 2019 during two follow‐up visits. LA function was analyzed as quintiles. Multivariable logistic regression examined odds of incident frailty.ResultsMedian (interquartile range [IQR]) age was 74 (71–77) years, 58% were female, and 214 (7%) participants developed frailty during a median (IQR) follow‐up of 6.3 (5.6–6.8) years. After adjusting for baseline confounders and incident cardiovascular events during follow‐up, the odds of developing frailty was 2.42 (1.26–4.66) times greater among participants in the lowest (vs highest) quintile of LA reservoir strain and 2.41 (1.11–5.22) times greater among those in the highest (vs lowest) quintile of LA stiffness index. Worse LA function was significantly associated with the development of exhaustion, but not the other components of the Fried frailty phenotype.ConclusionsWorse LA function is associated with higher incidence of frailty and exhaustion component independent of LA size and left ventricular function. Future studies are needed to elucidate the underlying mechanisms that drive the observed association.
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来源期刊
CiteScore
10.00
自引率
6.30%
发文量
504
审稿时长
3-6 weeks
期刊介绍: Journal of the American Geriatrics Society (JAGS) is the go-to journal for clinical aging research. We provide a diverse, interprofessional community of healthcare professionals with the latest insights on geriatrics education, clinical practice, and public policy—all supporting the high-quality, person-centered care essential to our well-being as we age. Since the publication of our first edition in 1953, JAGS has remained one of the oldest and most impactful journals dedicated exclusively to gerontology and geriatrics.
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