Hees Paul S, Fleg Jerome L, Lakatta Edward G, Shapiro Edward P
Department of Medicine and Division of Cardiology, School of Medicine, The Johns Hopkins Medical Institutions, Baltimore, Maryland 21224, USA.
Am J Cardiol. 2002 Dec 1;90(11):1231-6. doi: 10.1016/s0002-9149(02)02840-0.
Echocardiographic left ventricular (LV) wall thickness increases with age, suggesting LV hypertrophy. However, autopsy studies have shown no change, or even a decrease, in LV mass with age. With many pathologies, LV remodeling results in changes in ventricular shape. Age-associated LV shape change might explain this discrepancy, although this has not been studied. Magnetic resonance imaging (MRI) was used in 336 healthy, normotensive adults (mean age 56 +/- 18 years; 200 women, 136 men) to measure LV mass, end-diastolic LV wall thickness, length, diameter, and shape. Echocardiographic LV mass was measured in a subset of 86 subjects by a standard algorithm. In women, LV wall thickness increased by 14% (r = 0.19, p <0.02), whereas LV length decreased by 9% (r = -0.26, p = 0.0006); LV diameter was unchanged. Thus, LV mass did not vary with age (r -0.04, p = 0.06) and the sphericity index decreased (r = -0.165, p <0.05). In men, LV wall thickness and diameter were unrelated to age, but there was an 11% decrease in LV length (r = -0.29, p = 0.003); therefore, there was an 11% decrease in LV mass (r = -0.20, p = 0.019) and a decrease in the sphericity index (r = -0.218, p <0.04). No change occurred in echocardiographic LV mass with age in either gender, although echocardiographic LV wall thickness increased in both. The left ventricle becomes more spherical with age in normal adults due to reduced LV length. In women, increased LV wall thickness offsets the decreasing LV length, whereas in men, LV wall thickness fails to compensate, resulting in decreased LV mass with age.
超声心动图显示左心室（LV）壁厚度随年龄增加，提示左心室肥厚。然而，尸检研究表明，左心室质量并未随年龄增长而改变，甚至有所下降。在许多病理情况下，左心室重构会导致心室形状改变。年龄相关的左心室形状变化可能解释了这种差异，尽管尚未对此进行研究。对336名健康、血压正常的成年人（平均年龄56±18岁；女性200名，男性136名）进行磁共振成像（MRI）检查，以测量左心室质量、舒张末期左心室壁厚度、长度、直径和形状。通过标准算法对86名受试者的子集进行超声心动图左心室质量测量。在女性中，左心室壁厚度增加了14%（r = 0.19，p <0.02），而左心室长度减少了9%（r = -0.26，p = 0.0006）；左心室直径未变。因此，左心室质量不随年龄变化（r -0.04，p = 0.06），球形指数降低（r = -0.165，p <0.05）。在男性中，左心室壁厚度和直径与年龄无关，但左心室长度减少了11%（r = -0.29，p = 0.003）；因此，左心室质量减少了11%（r = -0.20，p = 0.019），球形指数降低（r = -0.218，p <0.04）。在任何性别中，超声心动图测量的左心室质量均未随年龄变化，尽管超声心动图测量的左心室壁厚度在两性中均增加。由于左心室长度缩短，正常成年人的左心室随年龄增长变得更接近球形。在女性中，左心室壁厚度增加抵消了左心室长度的减少，而在男性中，左心室壁厚度未能起到补偿作用，导致左心室质量随年龄下降。
