Heart Institute, Hadassah-Hebrew University Medical Center, Hebrew University Hadassah Medical School, Jerusalem, Israel.
Am J Cardiol. 2011 Aug 1;108(3):465-70. doi: 10.1016/j.amjcard.2011.03.070. Epub 2011 May 19.
Individuals aged >85 years constitute the world's most rapidly growing age group. Despite the rapid growth of this population and its high incidence of cardiovascular morbidity, normative data concerning cardiac structure and function are limited. The objective of this study was to define cardiac structure and function in an age-homogenous, community-dwelling population of subjects born in 1920 and 1921. Subjects were recruited from the Jerusalem Longitudinal Cohort Study. Echocardiography was performed using a portable echocardiograph at the subject's place of residence. Standard echocardiographic assessment of cardiac structure and function was performed. Four hundred fifty subjects (219 men, 231 women) were enrolled in the study. The cohort exhibited large left atrial volumes (64.6 ± 26 ml) and high left ventricular (LV) mass indexes (122 ± 36 g/m(2)) with normal LV volumes. Ejection fractions were preserved (55.3 ± 10.2%), but tissue Doppler s-wave velocities (lateral 7.8 ± 2.1 cm/s, septal 6.7 ± 1.9 cm/s) were reduced. Reduced tissue Doppler e waves (lateral 7.3 ± 2.2 cm/s, septal 6.2 ± 2 cm/s) and elevated E/e' ratios (12.2 ± 4.9) indicated significantly impaired diastolic function. In conclusion, the findings of this study demonstrate a high prevalence of left atrial enlargement, elevated LV mass, evidence of LV systolic dysfunction with preserved ejection fractions, and significant LV diastolic dysfunction in a community-dwelling cohort of 85-year-olds. The finding of elevated E/e' ratios in a subset free of known cardiovascular disease should be considered when clinical assessment of LV diastolic dysfunction in this age group is performed.
个体年龄>85 岁构成了世界上增长最快的年龄组。尽管这一人群迅速增长，且心血管发病率较高，但有关心脏结构和功能的规范数据有限。本研究的目的是在出生于 1920 年和 1921 年的年龄相同、居住在社区的人群中确定心脏结构和功能。研究对象从耶路撒冷纵向队列研究中招募。使用便携式超声心动图在研究对象的住所进行超声心动图检查。对心脏结构和功能进行标准超声心动图评估。共有 450 名受试者（219 名男性，231 名女性）入组研究。该队列的左心房容积较大（64.6±26ml），左心室（LV）质量指数较高（122±36g/m²），但 LV 容积正常。射血分数保留（55.3±10.2%），但组织多普勒 s 波速度（侧壁 7.8±2.1cm/s，间隔 6.7±1.9cm/s）降低。组织多普勒 e 波降低（侧壁 7.3±2.2cm/s，间隔 6.2±2cm/s），E/e'比值升高（12.2±4.9），提示舒张功能明显受损。总之，这项研究的结果表明，在一个居住在社区的 85 岁人群中，左心房扩大、LV 质量增加、LV 收缩功能障碍但射血分数保留、以及显著的 LV 舒张功能障碍的患病率较高。在一组无已知心血管疾病的人群中发现 E/e'比值升高，在评估该年龄组 LV 舒张功能障碍时应考虑这一点。
