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성인의 좌심방과 좌심실 크기변화에 미치는 영향 요인 분석

Analysis of Factors Influencing Changes in Left Atrium and Left Ventricle Size in Adults

  • 김선화 (화명일신기독병원 영상의학과) ;
  • 양성희 (부산가톨릭대학교 방사선학과)
  • Sun-Hwa Kim (Department of Radiology, HwaMyeong Ilsin christian Hospital) ;
  • Sung-Hee Yang (Department of Radiological Science, College of Health Sciences, Catholic University of Pusan)
  • 투고 : 2024.02.15
  • 심사 : 2024.03.08
  • 발행 : 2024.04.30

초록

This study analysed the factors that predict and influence heart disease through key indicators related to changes in left atrial and left ventricular size. Measurements recommended by the American Society of Echocardiography were used, and the influence of variables was assessed using multiple regression analysis. The results showed that left atrial volume index(LAVI) was significantly different by age, obesity, diabetes, hypertension, dyslipidaemia, and left ventricular relaxation dysfunction(p<0.05). Left ventricular mass index(LVMI) was significantly different according to age, body mass index, hypertension, diabetes, dyslipidaemia, and left ventricular relaxation dysfunction(p<0.05). Increases in LVMI and relative ventricular wall thickness(RWT) were associated with changes in LAVI(p<0.05). Age, systolic blood pressure, increased LAVI, and RWT influenced changes in LVMI, and left ventricular dysfunction was analysed as an influencing factor for both changes in LAVI and LVMI. Therefore, changes in left atrial and left ventricular size are indicators for early diagnosis and prevention of heart disease, and it is necessary to carefully observe structural changes in the heart and actively manage risk factors for the prevention and management of heart disease.

키워드

과제정보

This paper was supported by RESEARCH FUND offered from Catholic University of Pusan in 2023

참고문헌

  1. HRA Releases 'State of Heart Disease Care'. Health Insurance Review and Assessment Service. 2023.11.7.
  2. Ferket BS, Colkesen EB, Visser JJ, Spronk S, Kraaijenhagen RA, Steyerberg EW, et al. Systematic review of guidelines on cardiovascular risk assessment: Which recommendations should clinicians follow for a cardiovascular health check? Archives of Internal Medicine. 2010;170(1):27-40. DOI: 10.1001/archinternmed.2009.434
  3. Otterstad JE, St John Sutton MG, Froeland GS, Holme I, Skjaerpe T, Hall C. Prognostic value of two-dimensional echocardiography and N-terminal proatrial natriuretic peptide following an acute myocardial infarction. Assessment of baseline values(2-7days) and changes at 3 months in patients with a preserved systolic function. European Heart Journal. 2002; 23(13):1011-20. DOI: 10.1053/euhj.2001.2969
  4. St John Sutton MS, Pfeffer MA, Plappert T, Rouleau JL, Moye LA, Dagenais GA, et al. Quantitative two-dimension echocardiographic measurements are major predictors of adverse cardiovascular events after acute myocardial infarction. The protective effects of captopril. Circulation. 1994;89(1):68-75. DOI: 10.1161/01.CIR.89.168
  5. Wong M, Johnson G, Shabetai R, Hughes V, Bhat G, Lopez B, et al. Echocardiographic variables as prognostic indicators and therapeutic monitors in chronic congestive heart failure. Veterans affairs cooperative studies V-HeFT I and II. V-HeFT VA cooperative studies group. Circulation. 1993;87(6 Suppl):V165-70.
  6. Woroniecki RP, Kahnauth A, Panesar LE, Markovina KS. Left ventricular hypertrophy in pediatric hypertension: A mini review. Frontiers in Pediatrics. 2017;5(101):1-7. DOI: 10.3389/fped.2017.00101
  7. Levy D, Garrison RJ, Savage DD, Kannel WB, Castelli WP. Prognostic implications of echocardiographically determined left ventricular mass in the Framingham Heart Study. New England Journal of Medicine. 1990; 322(22):1561-6. DOI: 10.1056/NEJM199005313222203
  8. Nishimura RA, Tajik AJ. Evaluation of diastolic filling of left ventricle in health and disease: Doppler echocardiography is the clinician's Rosetta Stone. Journal of the American College of Cardiology. 1997;30(1):8-18. DOI: 10.1016/S0735-1097(97)00144-7
  9. Oh JK, Appleton CP, Hatle LK, et al. The noninvasive assessment of left ventricular diastolic function with two-dimensional and Doppler echocardiography. Journal of the American Society of Echocardiography. 1997;10(3):246-70. DOI: 10.1016/s0894-7317(97)70062-2
  10. Garcia MJ, Thomas JD, Klein AL. New Doppler echocardiographic applications for the study of diastolic function. Journal of the American College of Cardiology. 1998;32(4):865-75. DOI: 10.1016/s0735-1097(98)00345-3
  11. Appleton CP, Galloway JM, Gonzalez MS, Gaballa M, Basnight MA. Estimation of left ventricular filling pressures using two-dimensional and Doppler echocardiography in adult patients with cardiac disease. Journal of the American College of Cardiology. 1993; 22(7):1972-82. DOI: 10.1016/0735-1097(93)90787-2
  12. Bae HJ, Ha MJ, Kim JK. Correlation of left atrial enlargement and metabolic syndrom risk factors in echocardiography. Journal of Radiological Science and Technology. 2020;343(3):177-85. DOI: 10.17946/JRST.2020.43.3.177
  13. Patel DA, Lavie CJ, Milani RV, Shah S, Gilliland Y. Clinical implication of left atrial enlargement: A review. The Ochsner Journal. 2009;9(4):191-6. DOI: 1031486/toj.18.0148 1031486/toj.18.0148
  14. Stritzke J, Markus MRP, Duderstadt S, Lieb W, Luchner A, Doring A, et al. The aging process of the heart: Obesity is the main risk factor for left atrial enlargement during aging: The MONICA/KORA(monitoring of trends and determinations in cardiovascular disease/cooperative research in the region of augsburg) study. Journal of American College of Cardiology. 2009;54(21):1982-9. DOI: 10.1016/j.jacc.2009.07.034
  15. Lang R, Badano L, Mor-Avi V, Afilalo J, Armstrong A, Ernande L, et al. Recommendations for cardiac chamber quantification by echocardiography in adults: An update from the american society of echocardiography and the european association of cardiovascular imaging. J Am Soc Echocardiogr. 2015;28(1):1-39. DOI: 10.1016/j.echo.2014.10.003
  16. Galderisi M, Cosyns B, Edvardsen T, Cardim N, Delgado V, Di Salvo G, et al. Standardization of adult transthoracic echocardiography reporting in agreement with recent chamber quantification, diastolic function, and heart valve disease recommendations: An expert consensus document of the European Association of Cardiovascular Imaging. European Heart Journal-Cardiovascular Imaging. 2017;18(12): 1301-10. DOI: 10.1093/ehjci/jex244
  17. Kim KK, Haam JH, Kim BT, Kim EM, Park JH, Rhee SY, et al. Evaluation and treatment of obesity and its comorbidities: 2022 update of clinical practice guidelines for obesity by the Korean society for the study of obesity. Journal of Obesity & Metabolic Syndrome. 2023;32(1):1-24. DOI: 10.7570/jomes23016
  18. McCormack T, Boffa RJ, Jones NR, Carville S, McManus RJ. The 2018 ESC/ESH hypertension guideline and the 2019 NICE hypertension guideline, how and why they differ. European Heart Journal. 2019;40:3456-8.DOI: 10.1093/eurheartj/ehz681
  19. Meris A, Amigoni M, Uno H, Thune JJ, Verma A, Kober L, et al. Left atrial remodelling in patients with myocardial infarction complicated by heart failure, left ventricular dysfunction, or both: The VALIANT Echo study. European Heart Journal. 2009;30(1):56-65. DOI: 10.1093/eurheartj/ehn499
  20. Teresa SMT, Marion EB, Bernard JG, Kent RB, James BS. Left atrial volume as a morphophysiologic expression of left ventricular diastolic dysfunction and relation to cardiovascular risk burden. The American Journal of Cardiology. 2002;90(12):1284-9. DOI: 10.1016/s0002-9149(02)02864-3
  21. Anderson CA, Kiang L, Cora E, Lewis CE, Sidney S, Colangelo LA, et al. Left atrial dimension an traditional cardiovascular risk factors predict 20-year clinical cardiovascular events in young healthy adults: The CARDIA study. European Heart Journal-Cardiovascular Imaging. 2014;15(8):893-9. DOI: 10.1093/ehjci/jeu018
  22. Zia I, Johnson L, Memarian E, Borne Y, Engstrom G. Anthropometric measures and the risk of developing atrial fibrillation: A Swedish cohort study. BMC Cardiovas Discord. 2021;21(1):1-10. DOI: 10.1186/s12872-021-02415-6
  23. Wang TJ, Parise H, Levy D, D'Agostino Sr RB, Wolf PA, Vasan RS, et al. Obesity and the risk of new-onset atrial fibrillation. JAMA. 2004;292 (20):2471-7. DOI: 10.1001/jama.292.20.2471
  24. Osranek M, Bursi F, Bailey KR, Grossardt BR, Brown Jr RD, Kopecky SL, et al. Left atrial volume predicts cardiovascular events in patients originally diagnosed with lone atrial fibrillation: Three-decade follow-up. European Heart Journal. 2005;26(23):2556-61. DOI: 10.1093/eurheartj/ehi483
  25. Pavlopoulos H, Nihoyannopoulos P. Left atrial size: A structural expression of abnormal left ventricular segmental relaxation evaluated by strain echocardiography. European Journal of Echocardiography. 2009;10(7): 865-71. DOI: 10.1093/ejechocard/jep093
  26. Oh MS, Ahn JH, Lee WS. Echocardiographic diagnosis of diabetic cardiomyopathy. Clinical Ultrasound. 2020;5(1):17-23. DOI: 10.18525/cu.2020.5.1.17
  27. Jung CH, Son JW, Kang S, Kim WJ, Kim HS, Kim HS, et al. Diabetes fact sheets in Korea, 2020: An appraisal of current status. Diabetes & Metabolism Journal. 2021;45(1):1-10. DOI: 10.4093/dmj.2020.0254
  28. Park SM, Ro YM, Ahn JC, Lim DS, Park CG, Kim YH, et al. An appraisal of the electrocardiographic criteria for diagnosis of left ventricular hypertrophy in Koreans: Comparison to echocardiographic measurement of left ventricular mass. Korean Circulation Journal. 2004;34(8):775-83. DOI: 10.4070/kcj.2004.34.8.775