Ollivier J P, Gaillard J F, Quatre J M, Assoun B, Bussy E, Plotton C
Service de cardiologie, Hôpital militaire du Val-de-Grâce, Paris.
Arch Mal Coeur Vaiss. 1990 Jul;83(8):1143-7.
Because of discrepancy in interpretation of early diastolic filling indices in normal subjects and hypertensive, we studied the correlations between age and radionuclide angiographic peak filling rate (PFR), doppler echocardiographic early E and late A waves, left ventricular mass (LVM), blood pressure (BP) and ejection fraction (EF) in cautiously screened 30 untreated hypertensive and 30 age paired normal subjects (mean of age 52 +/- 17 ranging from 34 to 78 years). No patient had gross obesity nor coronary artery disease. Univariate analysis revealed strong correlations between LV filling and age in normal (r = -0.82 p less than 0.0001) and hypertensive (r = -0.61 p less than 0.001), with a very significant difference in y intercepts (t = 0.61 p = 10(-6)). LVM correlated poorly with age (r = 0.35 p less than 0.05) but with none of the LV filling indexes. BP correlated with PFR (r = 0.33 p less than 0.05) and A wave (r = 0.44 p less than 0.02) in hypertensive only. After multivariate analysis, significant dependencies of PFR, age, LV mass were more accurate if BP was in a higher range. The variability of the values of LV filling indexes was wider in hypertensive than in normotensive. Normotensive aging and hypertension have similar effects on the cardiovascular system. In the most aged people even without apparent cardiac disease, it is not possible to identify the specific effects of hypertension on diastolic function.
由于正常人和高血压患者在舒张早期充盈指标的解读上存在差异，我们对30例未经治疗的高血压患者和30例年龄匹配的正常受试者（年龄范围34至78岁，平均年龄52±17岁）进行了仔细筛查，研究年龄与放射性核素血管造影峰值充盈率（PFR）、多普勒超声心动图早期E波和晚期A波、左心室质量（LVM）、血压（BP）及射血分数（EF）之间的相关性。所有患者均无明显肥胖或冠状动脉疾病。单因素分析显示，正常受试者（r = -0.82，p < 0.0001）和高血压患者（r = -0.61，p < 0.001）的左心室充盈与年龄之间存在强相关性，截距差异非常显著（t = 0.61，p = 10^(-6)）。LVM与年龄的相关性较差（r = 0.35，p < 0.05），与任何左心室充盈指标均无相关性。仅在高血压患者中，BP与PFR（r = 0.33，p < 0.05）和A波（r = 0.44，p < 0.02）相关。多因素分析后发现，如果BP处于较高范围，PFR、年龄、左心室质量之间的显著相关性更为准确。高血压患者左心室充盈指标值的变异性比血压正常者更大。血压正常的衰老和高血压对心血管系统有相似的影响。在年龄最大的人群中，即使没有明显的心脏疾病，也无法确定高血压对舒张功能的具体影响。
