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左心室舒张功能的年龄和性别特异性变化:一项针对健康个体的多普勒超声心动图研究

Age- and gender-specific changes in the left ventricular relaxation: a Doppler echocardiographic study in healthy individuals.

作者信息

Okura Hiroyuki, Takada Yuko, Yamabe Azusa, Kubo Tomoichiro, Asawa Koichiro, Ozaki Takeshi, Yamagishi Hiroyuki, Toda Iku, Yoshiyama Minoru, Yoshikawa Junichi, Yoshida Kiyoshi

机构信息

Division of Cardiology, Bell Land General Hospital, Sakai, Japan.

出版信息

Circ Cardiovasc Imaging. 2009 Jan;2(1):41-6. doi: 10.1161/CIRCIMAGING.108.809087.

Abstract

BACKGROUND

Although left ventricular diastolic function has been shown to deteriorate with advancing age, its gender-specific change is unknown. The aim of this study was to investigate age- and gender-specific changes in tissue Doppler-derived left ventricular diastolic index, E'.

METHODS AND RESULTS

A total of 1333 healthy individual without known heart disease or hypertension (mean age, 55 years; range, 10 to 89) were enrolled and studied. Peak early mitral annular velocity (E') and peak late mitral annular velocity (A') were recorded and measured. As an index of the left ventricular relaxation, E' was used. As an index of the left ventricular filling pressure, E/E' was calculated. Although systolic indices poorly correlated with age, diastolic indices correlated well with age. Among those aged 30 to 39 and 40 to 49 years, E' was significantly lower in males than in females. In subjects aged 50 to 59 and 60 to 69 years, E' was similar in both genders. Among those aged 70 to 79 and 80 to 89 years, E' was significantly lower in females than in males. Predictors of the lowest quartile of E' among subjects aged >50 years were age (P<0.0001; chi(2)=66.11; odds ratio, 1.08; 95% CI, 1.058 to 1.097) and female gender (P=0.002; chi(2)=9.23; odds ratio, 1.68; 95% CI, 1.202 to 2.343).

CONCLUSIONS

Age-related changes in diastolic indices were gender specific. In the elderly population, diastolic function deteriorated more significantly in the female gender than in the male gender. These results may explain the relatively higher incidence in elderly females among patients with diastolic heart failure and higher cardiovascular mortality in the female gender.

摘要

背景

尽管已证实左心室舒张功能会随着年龄增长而恶化,但其性别特异性变化尚不清楚。本研究的目的是调查组织多普勒衍生的左心室舒张指数E'的年龄和性别特异性变化。

方法与结果

共纳入1333名无已知心脏病或高血压的健康个体(平均年龄55岁;范围10至89岁)进行研究。记录并测量二尖瓣环早期峰值速度(E')和二尖瓣环晚期峰值速度(A')。使用E'作为左心室舒张的指标。计算E/E'作为左心室充盈压的指标。尽管收缩期指标与年龄相关性较差,但舒张期指标与年龄相关性良好。在30至39岁和40至49岁的人群中,男性的E'显著低于女性。在50至59岁和60至69岁的受试者中,两性的E'相似。在70至79岁和80至89岁的人群中,女性的E'显著低于男性。年龄>50岁的受试者中E'处于最低四分位数的预测因素为年龄(P<0.0001;χ²=66.11;优势比,1.08;95%可信区间,1.058至1.097)和女性性别(P=0.002;χ²=9.23;优势比,1.68;95%可信区间,1.202至2.343)。

结论

舒张期指标的年龄相关变化具有性别特异性。在老年人群中,女性舒张功能的恶化比男性更显著。这些结果可能解释了舒张性心力衰竭患者中老年女性发病率相对较高以及女性心血管死亡率较高的原因。

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