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目的探讨正常高值血压者静息心率与左心室肥厚(LVH)的关系及分析静息心率对LVH发生的预测价值。方法从广东省人民医院心内科门诊收集新诊断和(或)未予以药物治疗的未合并其他心血管疾病的正常高值血压者,按静息心率水平分3组:静息心率<70次/min为A组、70~<80次/min为B组、≥80次/min为C组,比较各组间资料的差异,多因素Logistic回归分析影响LVH的因素,并绘制工作特征(ROC)曲线分析静息心率对LVH的预测价值。结果共有394人纳入本研究,年龄(52.0±4.4)岁,其中A组183人(46.4%)、B组136人(34.5%)、C组75人(19.0%);各组间收缩压、舒张压、室间隔厚度、左心室后壁厚度(LVPWT)、左室质量指数(LVMI)及LVH发生率差异有统计学意义(均P<0.05),LVH发生率三组间逐渐升高(分别为2.7%、16.9%、48.0%,P<0.05)。多因素Logistic回归分析显示,年龄(OR=1.98,P<0.05)、静息心率(OR=5.28,P<0.01)是LVH的危险因素。静息心率与LVH间的ROC曲线显示:曲线下面积(AUC)=0.860(P<0.05),静息心率对LVH有较好的预测价值。结论在正常高值血压人群中,年龄、静息心率是LVH的危险因素,不同水平的静息心率对LVH的影响存在差异,静息心率对LVH有较好的预测价值。
Objective To investigate the relationship between resting heart rate (LVH) and left ventricular hypertrophy (LVH) in patients with normal high blood pressure and to analyze the predictive value of resting heart rate on the occurrence of LVH. Methods The patients with newly diagnosed and / or non-drug-treated normal high blood pressure without cardiopulmonary diseases were collected from Department of Cardiology, Guangdong Provincial People’s Hospital. The resting heart rate was divided into 3 groups: resting heart rate <70 / min for group A, 70 ~ 80 times / min for group B, ≥80 times / min for group C, and the differences of data between groups were compared. Multivariate Logistic regression analysis was used to analyze the factors influencing LVH and the working characteristics (ROC) Curve analysis of resting heart rate on LVH prediction. Results A total of 394 patients were enrolled in this study, with a mean age of 52.0 ± 4.4 years. Among them, 183 (46.4%) in group A, 136 (34.5%) in group B and 75 (19.0%) in group C had systolic blood pressure The diastolic blood pressure, interventricular septum thickness, left ventricular posterior wall thickness (LVPWT), left ventricular mass index (LVMI) and incidence of LVH were significantly different (all P <0.05) 2.7%, 16.9%, 48.0%, P <0.05). Logistic regression analysis showed that age (OR = 1.98, P <0.05) and resting heart rate (OR = 5.28, P <0.01) were the risk factors of LVH. The ROC curve between resting heart rate and LVH showed that the area under the curve (AUC) was 0.860 (P <0.05), resting heart rate had a better predictive value for LVH. Conclusion In normal high blood pressure population, age and resting heart rate are the risk factors of LVH. The effects of different levels of resting heart rate on LVH are different. Resting heart rate has a good predictive value for LVH.