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年龄特异性与中心动脉血压测量值和左心室质量指数的关系。

Age-specific association between invasively measured central blood pressure and left ventricular mass index.

机构信息

Division of Cardiology, Department of Internal Medicine, Boramae Medical Center, Seoul National University College of Medicine, Seoul, Korea.

出版信息

Clin Exp Hypertens. 2021 Jul 4;43(5):419-427. doi: 10.1080/10641963.2021.1896727. Epub 2021 Mar 10.

Abstract

The impact of age on the association between central aortic hemodynamics and left ventricular (LV) remodeling has not been well elucidated. We compared the relationship between measurements of central blood pressure (CBP) and LV mass index (LVMI) according to their ages (<50 years versus ≥50 years). A total of 305 consecutive subjects (64.4 ± 10.9 years, 60.7% males) who underwent invasive coronary angiography (ICA) for the evaluation of coronary artery disease were prospectively enrolled. Just before ICA, CBP was measured at the aortic root using a pig-tail catheter, and CBP indices, including aortic systolic blood pressure (aSBP), aortic pulse pressure (aPP), aortic fractional pulse pressure (=aPP/mean aortic pressure), and aortic pulsatility index (=aPP/diastolic aortic pressure), were recorded. All subjects underwent transthoracic echocardiography, and LVMI was measured on the same day of ICA. In simple linear correlation analyses, LVMI was associated with all CBP indices in subjects aged <50 years (n = 29) ( < .05 for each), but not in those aged ≥50 years (n = 276) ( > .05 for each). In the younger age group (≤50 years), multivariable analysis showed that aSBP (= 0.457, = .021) and aPP (= 0.610, = .006) had a significant association with LVMI after adjusting for possible confounding factors. The results remained consistent even when analyzed in a 1:1 propensity score-matched cohort. In conclusion, invasively measured aPP showed the closest association with LVMI in subjects aged <50 years, but not those aged ≥50 years. Aortic pulsatile hemodynamic status appears to have a greater effect on LV remodeling in younger people than in older people.

摘要

年龄对中心主动脉血流动力学与左心室(LV)重构之间关系的影响尚未得到充分阐明。我们比较了根据年龄(<50 岁与≥50 岁)测量中心血压(CBP)和 LV 质量指数(LVMI)之间的关系。前瞻性纳入了 305 例连续因冠心病行有创冠状动脉造影(ICA)评估的患者(64.4±10.9 岁,60.7%为男性)。在 ICA 之前,使用猪尾导管在主动脉根部测量 CBP,并记录 CBP 指数,包括主动脉收缩压(aSBP)、主动脉脉压(aPP)、主动脉分数脉压(=aPP/平均主动脉压)和主动脉搏动指数(=aPP/舒张主动脉压)。所有患者均接受了经胸超声心动图检查,并在 ICA 当天测量了 LVMI。在简单线性相关分析中,LVMI 与<50 岁(n=29)患者的所有 CBP 指数均相关(均<.05),但与≥50 岁(n=276)患者均不相关(均>.05)。在年龄较小的组(≤50 岁)中,多元分析显示,在调整可能的混杂因素后,aSBP(=0.457,=0.021)和 aPP(=0.610,=0.006)与 LVMI 有显著相关性。即使在 1:1 倾向评分匹配队列中进行分析,结果也是一致的。总之,在<50 岁的患者中,侵入性测量的 aPP 与 LVMI 的关联最密切,而在≥50 岁的患者中则没有。主动脉搏动性血流动力学状态对年轻人的 LV 重构影响似乎比老年人更大。

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