Onose Y, Oki T, Mishiro Y, Yamada H, Abe M, Manabe K, Kageji Y, Tabata T, Wakatsuki T, Ito S
Second Department of Internal Medicine, School of Medicine, The University of Tokushima, Tokushima, Japan.
J Am Soc Echocardiogr. 1999 Nov;12(11):921-6. doi: 10.1016/s0894-7317(99)70144-6.
Our objective was to evaluate the influence of aging on left ventricular (LV) regional systolic function along the long and short axes in clinically normal patients. We recorded LV wall motion velocity patterns at the mid-wall portion of the middle of the LV posterior wall in the parasternal long-axis view (short-axis direction) and at the endocardial portion of the middle of the LV posterior wall in the apical long-axis view (long-axis direction) with pulsed tissue Doppler imaging in 80 normal patients (age range 15 to 78 years). In all patients the LV pressure curve and its first derivative (dP/dt) were recorded. The systolic wave of the LV posterior wall motion velocity pattern exhibited 2 peaks, the first (Sw(1)) and second (Sw(2)) systolic waves. No significant changes were seen with aging in the percent LV fractional shortening determined by M-mode echocardiography, LV ejection fraction determined by left ventriculography, the peak Sw(1) and Sw(2) along the short axis, the peak Sw(2) along the long axis, and the peak dP/dt. The peak Sw(1) along the long axis correlated inversely with age (P <.0001) but did not correlate significantly with the peak dP/dt. These results suggest that shortening of the longitudinal fibers in early systole is impaired with increased age in healthy individuals. This impairment results in insufficient spherical change in the LV cavity, although global LV pump function and myocardial contractility are maintained.
我们的目的是评估衰老对临床正常患者左心室(LV)沿长轴和短轴的区域收缩功能的影响。我们使用脉冲组织多普勒成像技术,在80名正常患者(年龄范围15至78岁)中,记录了胸骨旁长轴视图(短轴方向)下左心室后壁中部中层的室壁运动速度模式,以及心尖长轴视图(长轴方向)下左心室后壁中部心内膜部分的室壁运动速度模式。在所有患者中记录了左心室压力曲线及其一阶导数(dP/dt)。左心室后壁运动速度模式的收缩波呈现两个峰值,即第一(Sw(1))和第二(Sw(2))收缩波。通过M型超声心动图测定的左心室分数缩短百分比、通过左心室造影测定的左心室射血分数、短轴方向的Sw(1)和Sw(2)峰值、长轴方向的Sw(2)峰值以及dP/dt峰值,在衰老过程中均未观察到显著变化。长轴方向的Sw(1)峰值与年龄呈负相关(P <.0001),但与dP/dt峰值无显著相关性。这些结果表明,在健康个体中,随着年龄的增长,早期收缩期纵向纤维的缩短会受到损害。尽管左心室整体泵功能和心肌收缩力得以维持,但这种损害会导致左心室腔球形变化不足。