Negri Francesca, Sala Carla, Re Annalisa, Mancia Giuseppe, Cuspidi Cesare
Department of Clinical Medicine and Prevention, University of Milano-Bicocca, Milano, Italy.
Blood Press. 2013 Feb;22(1):1-8. doi: 10.3109/08037051.2012.707307. Epub 2012 Aug 2.
The impact of aging on the relationship between left ventricular (LV) mass/geometry and diastolic function as assessed by updated echocardiographic methods, such as tissue Doppler, is poorly defined. We investigated this issue in a cohort of hypertensive patients.
A total of 660 hypertensives (mean age 65 ± 13 years, 48% men) with preserved LV systolic function underwent a comprehensive echo-Doppler examination for routine clinical indications. For the present analysis, the subjects have been divided in two age groups (<65 or ≥65 years).
Overall, 61% of subjects fulfilled the criteria for LVH, 18% for left atrial (LA) enlargement and 11% for altered LV filling index. Concentric LV geometry was 1.4-fold higher in older hypertensives than in younger counterparts; also the prevalence of LA enlargement and altered LV filling was 2.0- and 1.9-fold higher in the former group, respectively. In older hypertensives, at variance from younger ones, neither LV mass nor relative wall thickness (RWT), a continuous index of LV geometry, were independently correlated to conventional as well as tissue Doppler LV diastolic indexes.
Our findings suggest the relationship between cardiac hypertrophy and diastolic function in hypertensive subjects is affected by aging-associated factors unrelated to the amount of LV mass as assessed by standard echocardiography.
衰老对左心室（LV）质量/几何形态与舒张功能之间关系的影响，通过诸如组织多普勒等更新的超声心动图方法评估时，定义尚不明确。我们在一组高血压患者中研究了这个问题。
总共660名左心室收缩功能保留的高血压患者（平均年龄65±13岁，48%为男性）因常规临床指征接受了全面的超声多普勒检查。对于本分析，受试者被分为两个年龄组（<65岁或≥65岁）。
总体而言，61%的受试者符合左心室肥厚标准，18%符合左心房（LA）扩大标准，11%符合左心室充盈指数改变标准。老年高血压患者中同心性左心室几何形态比年轻患者高1.4倍；前一组中左心房扩大和左心室充盈改变的患病率分别比后一组高2.0倍和1.9倍。在老年高血压患者中，与年轻患者不同，左心室质量和相对壁厚度（RWT，左心室几何形态的连续指标）均与传统以及组织多普勒左心室舒张指标无独立相关性。
我们的研究结果表明，高血压患者中心脏肥厚与舒张功能之间的关系受与标准超声心动图评估的左心室质量无关的衰老相关因素影响。
