Lie J T, Hammond P I
Division of Pathology, Mayo Clinic, Rochester, MN 55905.
Mayo Clin Proc. 1988 Jun;63(6):552-64. doi: 10.1016/s0025-6196(12)64885-x.
Persons older than 85 years of age will constitute the fastest growing segment of the US population in the next decade, and despite the recent decline in mortality from heart disease, cardiovascular disease remains the single greatest cause of death in these elderly persons. We studied the pathologic changes in the hearts of 237 patients (93 men and 144 women) who had lived to the age of 90 years or older. The degree and extent of coronary atherosclerosis in these senescent hearts were similar to findings reported in younger patients who died of coronary heart disease, but calcification of the coronary arteries, mitral annulus, and aortic valve was more prevalent, as was cardiac amyloidosis. Multiple cardiac disorders were common in these very elderly hearts, but they seemed to play a lesser role in precipitating heart failure or shortening the life-span of the patients. Important factors in attaining longevity seem to be protection from the development of severe coronary artery disease by an unexplained mechanism and an innate resistance to cardiac dysfunction from a multitude of structural changes that occur with advancing age.
85岁以上的人群将成为未来十年美国人口中增长最快的部分。尽管近期心脏病死亡率有所下降，但心血管疾病仍是这些老年人的单一最大死因。我们研究了237例活到90岁及以上患者（93名男性和144名女性）心脏的病理变化。这些老年心脏中冠状动脉粥样硬化的程度和范围与死于冠心病的年轻患者的研究结果相似，但冠状动脉、二尖瓣环和主动脉瓣的钙化更为普遍，心脏淀粉样变性也是如此。多种心脏疾病在这些高龄心脏中很常见，但它们在引发心力衰竭或缩短患者寿命方面似乎作用较小。实现长寿的重要因素似乎是通过一种不明机制预防严重冠状动脉疾病的发生，以及对随着年龄增长而出现的多种结构变化所导致的心脏功能障碍具有先天抵抗力。
