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不同年龄的高血压男性和女性的血流动力学模式。

The hemodynamic patterns in hypertensive men and women of different age.

作者信息

Krzesiński P, Stańczyk A, Gielerak G, Piotrowicz K

机构信息

Department of Cardiology and Internal Diseases, Military Institute of Medicine, Warsaw, Poland.

出版信息

J Hum Hypertens. 2016 Mar;30(3):177-85. doi: 10.1038/jhh.2015.63. Epub 2015 Jul 2.

Abstract

Aging is associated with cardiovascular remodeling, which can be accelerated in arterial hypertension (AH). The aim of this study was to evaluate the relation between hemodynamic profile and age, as well as to identify the role of sex in hemodynamic patterns of aging in AH. The study comprised 326 patients with AH (mean age: 44.3 years). Two-dimensional echocardiography was performed to evaluate, that is, left ventricular diastolic dysfunction (LVDD) and ejection fraction (LVEF), and ICG to evaluate, that is, acceleration time index (ACI), velocity index (VI), total arterial compliance (TAC), systemic vascular resistance index (SVRI) and thoracic fluid content (TFC). The statistical analysis included interquartile comparison in subgroups of age <19-37 years (Q1), 38-44 years (Q2), 45-51 years (Q3) and 52-68 years (Q4). Aging was associated with: (1) higher prevalence of LVDD (Q1 vs Q4: 11.0% vs 24.7%, P=0.023); (2) altered LV systolic performance-ACI (81.4 vs 64.0 1/100 Ω s(-2), P=0.0001), VI (50.5 vs 42.8 1/1000 Ω s(-1), P=0.006), LVEF (65.4% vs 67.0%, NS); and (3) increased afterload-TAC (2.25 vs 1.87 ml mm Hg(-1), P=0.0001), SVRI (2182 vs 2407 dyn s m(2) cm(-)(5); P=0.045). The 'U-shaped' relation to age was observed for TFC. The above-mentioned hemodynamic trends were more pronounced in men, whereas females presented the 'middle-aged delay'. The influence of aging on cardiovascular system shows in progressive arterial stiffness and impaired left ventricular function. Thoracic fluid reduction may be compensatory to vasoconstriction but its efficiency declines with age. The patterns of cardiovascular aging are different in men and women.

摘要

衰老与心血管重塑相关,而在动脉高血压(AH)中这种关联可能会加速。本研究的目的是评估血流动力学特征与年龄之间的关系,并确定性别在AH衰老血流动力学模式中的作用。该研究纳入了326例AH患者(平均年龄:44.3岁)。采用二维超声心动图评估左心室舒张功能障碍(LVDD)和射血分数(LVEF),采用心阻抗图评估加速时间指数(ACI)、速度指数(VI)、总动脉顺应性(TAC)、体循环血管阻力指数(SVRI)和胸液含量(TFC)。统计分析包括对年龄<19 - 37岁(Q1)、38 - 44岁(Q2)、45 - 51岁(Q3)和52 - 68岁(Q4)亚组进行四分位数比较。衰老与以下情况相关:(1)LVDD患病率较高(Q1与Q4:11.0%对24.7%,P = 0.023);(2)左心室收缩功能改变——ACI(81.4对64.0 1/100Ωs(-2),P = 0.0001)、VI(50.5对42.8 1/1000Ωs(-1),P = 0.006)、LVEF(65.4%对67.0%,无显著性差异);(3)后负荷增加——TAC(2.25对1.87 ml mmHg(-1),P = 0.0001)、SVRI(2182对2407 dyn s m(2) cm(-)(5);P = 0.045)。观察到TFC与年龄呈“U形”关系。上述血流动力学趋势在男性中更为明显,而女性则表现出“中年延迟”。衰老对心血管系统的影响表现为动脉僵硬度逐渐增加和左心室功能受损。胸液减少可能是对血管收缩的一种代偿,但随着年龄增长其效率下降。心血管衰老模式在男性和女性中有所不同。

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