Circulation：右心室肥大或增加心衰和死亡风险

近日，刊登在国际著名杂志Circulation上的一项研究报告中，来自宾夕法尼亚大学的研究者表示，增厚心脏的右心室和病人高风险的心力衰竭以及心血管死亡率（除临床的心血管疾病）直接相关。

很多研究中，研究者都着重研究于易于成像的心脏左心室，左心室是心脏的一块受全身性的高血压和其它常见状况所影响的区域。医学博士Steven Kawut表示，但是我们也应该重点关注右心室，因为很多心脏和肺部的疾病都和右心室（right ventricle，RV）相关。这项研究揭示了，成年人中10项心衰事件和心血管死亡事件中就有一件是因为心脏右心室的增厚所导致的。

随后研究者对4114名平均年龄在61岁的男性和女性进行了右心室的心血管磁共振成像检测，这些参与者都加入了美国动脉粥样硬化多种族研究中（MESA）。研究发现，相比正常尺寸右心室的参与者来说，右心室肥大的参与者有双倍的心衰和死亡风险。当然，这种情况会随着年龄的改变、性别、种族、体重指数、教育程度、吸烟情况以及其他临床数据而持续存在。

研究者Kawut表示，这项研究发现于传统的想法背道而驰，传统观念认为右心室只是在临床心力衰竭中扮演着有限的角色。但是我们的研究发现揭示了右心室对于预测心血管疾病不良结果的风险异常重要。

编译自：Increased risk of heart failure and cardiovascular death linked to thickening of heart's right ventricle

doi:10.1161/​CIRCULATIONAHA.112.095216
PMC:
PMID:

Right Ventricular Structure is Associated with the Risk of Heart Failure and Cardiovascular Death: The MESA-Right Ventricle Study

Steven M. Kawut1*; R. Graham Barr2; João A.C. Lima3; Amy Praestgaard1; W. Craig Johnson4; Harjit Chahal3; Kofo O. Ogunyankin5; Michael R. Bristow6; Jorge R. Kizer7; Harikrishna Tandri3; David A. Bluemke8

Background—Changes in right ventricular (RV) morphology are associated with morbidity and mortality in heart and lung disease. We examined the association of abnormal RV structure and function with the risk of heart failure (HF) or cardiovascular death in a population-based multiethnic sample free of clinical cardiovascular disease at baseline.

Methods and Results—The Multi-Ethnic Study of Atherosclerosis (MESA) performed cardiac magnetic resonance imaging (MRI) on 5098 participants between 2000-2002 with follow-up for incident heart failure and cardiovascular death ("death") until January 2008. RV volumes and mass were available for 4204 participants. The study sample (N = 4,144) was 61.4 ± 10.1 years old and 47.6 % male. The presence of RV hypertrophy (increased RV mass) was associated with a more than twice the risk of heart failure or death after adjustment for demographics, body mass index, education, C-reactive protein level, hypertension, and smoking status (HR = 2.52, 95%CI 1.55-4.10, p < 0.001) and a doubling of risk (or more) with left ventricular mass at the mean value or lower (p for interaction = 0.05).

Conclusions—RV hypertrophy was associated with the risk of heart failure or death in a multi-ethnic population free of clinical cardiovascular disease at baseline.