Soma Johannes, Wisløff Ulrik, Tyldum Gjertrud Aunet, Schjerve Inga Ekeberg, Dahl Ketil, Widerøe Tor-Erik
Department of Cardiology St. Olavs University Hospital, Trondheim, Norway.
Blood Press. 2008;17(3):147-55. doi: 10.1080/08037050802184411.
The interaction between left ventricular (LV) apical rotation, blood pressure (BP) and body mass in elderly females may reveal mechanisms involved in the syndrome of diastolic heart failure.
Thirty-one healthy females, age 69-84 years, were studied with echocardiography, ambulatory BP and an exercise capacity (VO2peak) test.
LV apical short-axis loops were eligible for speckle tracking analysis in 27 subjects. Peak apical rotation (PAR) correlated inversely with diastolic BP (r = -0.47, p = 0.01). PAR correlated positively with stroke volume and body weight (p<0.05), but not with VO2peak (n = 19, p = ns). PAR also correlated with peak rotation velocity in systole (r = 0.76, p<0.0001) and in diastole (r = 0.58, p = 0.001). Diastolic peak rotation velocity correlated with mitral E wave peak velocity (r = 0.48, p = 0.01). There was a significant reduction in LV volumes during the 4 years of follow-up.
In healthy elderly females, there seems to be an interaction between LV apical rotation, BP and body mass. Peak apical rotation and peak diastolic rotation velocity correlate with indices of LV filling and ejection, indicating that suction, a crucial element for effective early LV filling, may be preserved in healthy elderly subjects. Suction deteriorates with elevations of the arterial BP. An age- and BP-related reduction in LV end-diastolic volume may represent an additional impediment to LV filling. Both features may contribute to the development of LV diastolic dysfunction and to episodes of diastolic heart failure.
老年女性左心室（LV）心尖旋转、血压（BP）和体重之间的相互作用可能揭示舒张性心力衰竭综合征所涉及的机制。
对31名年龄在69 - 84岁的健康女性进行了超声心动图、动态血压和运动能力（VO2峰值）测试。
27名受试者的LV心尖短轴环符合斑点追踪分析条件。心尖峰值旋转（PAR）与舒张压呈负相关（r = -0.47，p = 0.01）。PAR与每搏输出量和体重呈正相关（p<0.05），但与VO2峰值无关（n = 19，p =无统计学意义）。PAR还与收缩期峰值旋转速度（r = 0.76，p<0.0001）和舒张期峰值旋转速度（r = 0.58，p = 0.001）相关。舒张期峰值旋转速度与二尖瓣E波峰值速度相关（r = 0.48，p = 0.01）。在4年的随访期间，LV容积有显著减少。
在健康老年女性中，LV心尖旋转、BP和体重之间似乎存在相互作用。心尖峰值旋转和舒张期峰值旋转速度与LV充盈和射血指标相关，表明有效早期LV充盈的关键要素——抽吸，在健康老年受试者中可能得以保留。抽吸会随着动脉血压升高而恶化。与年龄和BP相关的LV舒张末期容积减少可能是LV充盈的另一个障碍。这两个特征可能都有助于LV舒张功能障碍的发展和舒张性心力衰竭的发作。
