D'Andrea Antonello, Vriz Olga, Ferrara Francesco, Cocchia Rosangela, Conte Marianna, Di Maio Marco, Driussi Caterina, Scarafile Raffaella, Martone Francesca, Sperlongano Simona, Tocci Giampaolo, Citro Rodolfo, Caso Pio, Bossone Eduardo, Golino Paolo
Department of Cardiology, Luigi Vanvitelli University, Monaldi Hospital, AORN Ospedali dei Colli, Naples, Italy.
Department of Cardiology and Emergency Medicine, San Antonio Hospital, San Daniele del Friuli, Udine, Italy.
J Cardiovasc Echogr. 2018 Apr-Jun;28(2):101-108. doi: 10.4103/jcecho.jcecho_57_17.
Transthoracic Doppler echocardiographic examination is commonly performed to define the diastolic ventricular function since it is widely available, noninvasive, and inexpensive with respect to other diagnostic imaging modalities. However, data regarding age- and gender-matched reference values are scanty and sometimes conflicting. This study aims to explore the physiologic variations of left ventricular (LV) ' ratio as assessed in a large cohort of healthy adults and to investigate clinical and echocardiographic correlates.
From June 2007 to February 2014, 1168 healthy Caucasian adults (mean age 45.1 ± 15.6 years) performed standard echocardiographic examination (transthoracic echocardiogram).
' constantly increases across all the age classes ( < 0.0001, analyses of variance both for males and females) with a strong statistically significant linear positive correlation with age. Stepwise multiple linear regression analysis identified age ( < 0.0001), LV mass ( < 0.001), LV end-diastolic volume ( < 0.01), and left atrial volume ( < 0.001) as the only independent determinants of ' ratio (model = 0.54, < 0.0001).
In healthy subjects, transmitral velocity to ' ratio changes in relation to the age: it increased with a statistically significant correlation in individuals older than 60 years. Hence, differences related to demographic and anthropometric measurements may potentially develop a misclassification of otherwise normal individuals when established on dichotomically suggested normal reference values. Our study can demonstrate that it is indispensable to apply specific cutoff related to the age and gender to properly assess LV diastolic function.
经胸多普勒超声心动图检查常用于定义舒张期心室功能，因为相对于其他诊断成像方式，它广泛可用、无创且成本低廉。然而，关于年龄和性别匹配的参考值的数据很少，有时甚至相互矛盾。本研究旨在探讨在一大群健康成年人中评估的左心室（LV）“比值”的生理变化，并研究临床和超声心动图相关性。
从2007年6月至2014年2月，1168名健康的白种成年人（平均年龄45.1±15.6岁）接受了标准超声心动图检查（经胸超声心动图）。
“比值”在所有年龄组中持续增加（男性和女性的方差分析均P<0.0001），与年龄呈强统计学显著线性正相关。逐步多元线性回归分析确定年龄（P<0.0001）、左心室质量（P<0.001）、左心室舒张末期容积（P<0.01）和左心房容积（P<0.001）是“比值”的唯一独立决定因素（模型R²=0.54，P<0.0001）。
在健康受试者中，二尖瓣血流速度与“比值”随年龄变化：在60岁以上个体中其增加具有统计学显著相关性。因此，当基于二分法建议的正常参考值时，与人口统计学和人体测量学测量相关的差异可能会导致对原本正常个体的错误分类。我们的研究表明，应用与年龄和性别相关的特定临界值来正确评估左心室舒张功能是必不可少的。
