Dahan M, Mérillon J P, Cohen-Solal A, Paillole C, Guiomard A, Gourgon R
Service de Cardiologie, Hôpital Bichat, Paris.
Presse Med. 1992 Jul 22;21(26):1222-6.
In a haemodynamic and angiographic study at rest conducted in 25 men aged from 22 to 68 years who had no more than another risk factor for arterial disease and showed no evidence of cardiac or arterial disease several parameters were measured or calculated. Firstly, a global index of arterial system function (Ea) and its various factors: Ea = ESP/SV [ESP: left ventricular end-systolic pressure; SV: systolic volume]; Ea = (HR x TSR)+Ea' [HR: heart rate/min; TSR: total systemic resistance] where Ea' = (ESP - AoP/SV) [AoP: mean aortic pressure]. Secondly, the parameters concerning the left ventricle were the mass (m) and the m/EDV ratio [EDV: end-diastolic volume] and indices of the left ventricular systolic and diastolic functions, such as ELV = ESP/ESV [ESV: end-systolic volume], kp: the volumic distensibility module of the left ventricular chamber; relations EF - o ES [EF: ejection fraction; o ES: end-systolic constraint], and kp - m/EDV as indice of left ventricular muscle distensibility. In parallel with the subjects' age, Ea increased by joint augmentation of TSR and Ea' while m, m/EDV, ELV and kp also significantly increased. The inotropic quality of the left ventricular muscle and its intrinsic distensibility were found to be decreased in a few subjects aged over 45. Ea/ELV (reverse of ejection fraction -1) tended to increase (ELV relatively less than Ea), but this increase was not significant (P = 0.10). These results show that in the ageing man the improvement observed in the ejection fraction of the left ventricular pump corresponds roughly to the degradation of the arterial system transfer function, and the arterial system-left ventricle coupling, evaluated by the Ea/ELV ratio, is maintained (better in fact than in arterial hypertension and heart failure). This improvement is achieved by increases of m and, chiefly, m/EDV which compensate for both the increase of Ea and the relative decline of left ventricular muscle contractile quality. There is a disorder of the left ventricular pump diastolic function which is due to geometric changes in the chamber and to changes in the intrinsic distensibility of the left ventricular muscle.
在一项针对25名年龄在22至68岁之间男性的静息血流动力学和血管造影研究中，这些男性除了不超过一项动脉疾病风险因素外，未显示出心脏或动脉疾病的迹象，测量或计算了几个参数。首先，是动脉系统功能的整体指数（Ea）及其各种因素：Ea = ESP/SV [ESP：左心室收缩末期压力；SV：收缩期容积]；Ea = (HR x TSR)+Ea' [HR：心率/分钟；TSR：总全身阻力]，其中Ea' = (ESP - AoP/SV) [AoP：平均主动脉压力]。其次，与左心室相关的参数有质量（m）和m/EDV比值[EDV：舒张末期容积]以及左心室收缩和舒张功能指标，如ELV = ESP/ESV [ESV：收缩末期容积]，kp：左心室腔的容积扩张模量；关系EF - o ES [EF：射血分数；o ES：收缩末期约束]，以及kp - m/EDV作为左心室肌肉扩张性指标。与受试者年龄相关，Ea通过TSR和Ea'的共同增加而升高，同时m、m/EDV、ELV和kp也显著增加。在一些45岁以上的受试者中，发现左心室肌肉的变力质量及其固有扩张性有所下降。Ea/ELV（射血分数倒数 -1）趋于升高（ELV相对低于Ea），但这种升高不显著（P = 0.10）。这些结果表明，在老年男性中，左心室泵射血分数的改善大致对应于动脉系统传递功能的退化，并且通过Ea/ELV比值评估的动脉系统 - 左心室耦合得以维持（实际上比在动脉高血压和心力衰竭中更好）。这种改善是通过m的增加实现的，主要是m/EDV的增加，其补偿了Ea的增加以及左心室肌肉收缩质量的相对下降。左心室泵舒张功能存在紊乱，这是由于心室几何形状变化以及左心室肌肉固有扩张性变化所致。
