年龄对系统性动脉高血压患者左心房功能与左心室收缩和舒张功能之间关系的影响。

Influence of age on the relationship between left atrial performance and left ventricular systolic and diastolic function in systemic arterial hypertension.

作者信息

Cioffi Giovanni, Mureddu Gian Francesco, Stefenelli Carlo

机构信息

Department of Cardiology, Villa Bianca Hospital, Trento.

出版信息

Exp Clin Cardiol. 2006 Winter;11(4):305-10.

PMID:18651023

原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC2274841/

Abstract

BACKGROUND

Changes in left ventricular (LV) systolic and diastolic properties may generate variations in left atrial (LA) size and function in many pathophysiological models of LV overload. Besides these states, increasing age may independently influence and magnify LA changes.

OBJECTIVE

To investigate the relation of LA size and function to increasing age in hypertensive patients, and to evaluate whether this relationship is influenced by LV function.

METHODS

Three hundred thirty-six patients were evaluated using Doppler echocardiography. Maximal LA volume and ejection force were used as indexes of LA size and performance, respectively.

RESULTS

Age was positively associated with LA ejection force (r=0.34, P<0.001) and maximal volume (r=0.25, P<0.001). The effect of age was independent of LV mass and LV concentric geometry, which independently influenced LA parameters. The relationship between age and LA ejection force was maintained in patients with and without LV systolic dysfunction, and in those with normal diastolic function, whereas it was lost in those with LV diastolic dysfunction. The relationship between age and LA size was not influenced by either LV systolic or diastolic function. LA ejection force was associated with LV mass and LV concentric geometry in all groups of patients 56 years or older, while no association was found between these variables in patients younger than 56 years. LV mass was systematically linked to maximal LA volume in all classes of age, together with LV end-diastolic volume in all groups of patients 56 years of age or older, and LV concentric geometry in patients 68 years of age or older.

CONCLUSIONS

There is a positive relationship between age and LA size and performance in hypertensive patients, which is independent of LV mass and geometry. The effect of age on LA performance is insignificant when diastolic dysfunction occurs.

摘要

背景

在许多左心室（LV）负荷过重的病理生理模型中，左心室收缩和舒张特性的改变可能导致左心房（LA）大小和功能的变化。除了这些状态外，年龄增长可能独立影响并放大左心房的变化。

目的

研究高血压患者左心房大小和功能与年龄增长的关系，并评估这种关系是否受左心室功能的影响。

方法

采用多普勒超声心动图对336例患者进行评估。最大左心房容积和射血力分别用作左心房大小和功能的指标。

结果

年龄与左心房射血力呈正相关（r = 0.34，P < 0.001），与最大容积呈正相关（r = 0.25，P < 0.001）。年龄的影响独立于左心室质量和左心室向心性几何结构，而左心室质量和左心室向心性几何结构独立影响左心房参数。年龄与左心房射血力之间的关系在有或无左心室收缩功能障碍的患者以及舒张功能正常的患者中均存在，而在有左心室舒张功能障碍的患者中则消失。年龄与左心房大小之间的关系不受左心室收缩或舒张功能的影响。在所有56岁及以上的患者组中，左心房射血力与左心室质量和左心室向心性几何结构相关，而在56岁以下的患者中未发现这些变量之间的关联。在所有年龄段，左心室质量均与最大左心房容积系统相关，在所有56岁及以上的患者组中与左心室舒张末期容积相关，在68岁及以上的患者中与左心室向心性几何结构相关。