Grassow Leonhard, Gröschel Jan, Saad Hadil, Krüger Leo Dyke, Kuhnt Johanna, Müller Maximilian, Hadler Thomas, Blaszczyk Edyta, Schulz-Menger Jeanette
Charité - Universitätsmedizin Berlin, corporate member of Freie Universität Berlin and Humboldt-Universität zu Berlin, ECRC Experimental and Clinical Research Center, Lindenberger Weg 80, 13125, Berlin, Germany.
Working Group on Cardiovascular Magnetic Resonance, Experimental and Clinical Research Center, a joint cooperation between Charité Medical Faculty and the Max-Delbrück Center for Molecular Medicine, Charité Campus Buch, Lindenberger Weg 80, 13125, Berlin, Germany.
Clin Res Cardiol. 2024 Mar 11. doi: 10.1007/s00392-024-02430-5.
Aging as a major non-modifiable cardiac risk factor challenges future cardiovascular medicine and economic demands, which requires further assessments addressing physiological age-associated cardiac changes.
Using cardiovascular magnetic resonance (CMR), this study aims to characterize sex-specific ventricular adaptations during healthy aging.
The population included healthy volunteers who underwent CMR at 1.5 or 3 Tesla scanners applying cine-imaging with a short-axis coverage of the left (LV) and right (RV) ventricle. The cohort was divided by sex (female and male) and age (subgroups in years): 1 (19-29), 2 (30-39), 3 (40-49), and 4 (≥50). Cardiac adaptations were quantitatively assessed by CMR indices.
After the exclusion of missing or poor-quality CMR datasets or diagnosed disease, 140 of 203 volunteers were part of the final analysis. Women generally had smaller ventricular dimensions and LV mass, but higher biventricular systolic function. There was a significant age-associated decrease in ventricular dimensions as well as a significant increase in LV mass-to-volume ratio (LV-MVR, concentricity) in both sexes (LV-MVR in g/ml: age group 1 vs. 4: females 0.50 vs. 0.57, p=0.016, males 0.56 vs. 0.67, p=0.024). LV stroke volume index decreased significantly with age in both sexes, but stronger for men than for women (in ml/m: age group 1 vs. 4: females 51.76 vs. 41.94, p<0.001, males 55.31 vs. 40.78, p<0.001). Ventricular proportions (RV-to-LV-volume ratio) were constant between the age groups in both sexes.
In both sexes, healthy aging was associated with an increase in concentricity and a decline in ventricular dimensions. Furthermore, relevant age-related sex differences in systolic LV performance were observed.
衰老作为一个主要的不可改变的心脏危险因素，对未来的心血管医学和经济需求构成挑战，这需要进一步评估与生理年龄相关的心脏变化。
本研究旨在利用心血管磁共振成像（CMR）来描述健康衰老过程中性别特异性的心室适应性变化。
研究人群包括在1.5或3特斯拉扫描仪上接受CMR检查的健康志愿者，采用电影成像技术，对左心室（LV）和右心室（RV）进行短轴覆盖。队列按性别（女性和男性）和年龄（以年为单位分组）分为：1组（19 - 29岁）、2组（30 - 39岁）、3组（40 - 49岁）和4组（≥50岁）。通过CMR指标对心脏适应性进行定量评估。
在排除缺失或质量不佳的CMR数据集或已诊断疾病后，203名志愿者中的140名参与了最终分析。女性通常心室尺寸和左心室质量较小，但双心室收缩功能较高。两性的心室尺寸均随年龄显著减小，左心室质量与容积比（LV - MVR，向心性）显著增加（LV - MVR，单位为g/ml：1组与4组相比：女性为0.50对0.57，p = 0.016；男性为0.56对0.67，p = 0.024）。两性的左心室每搏输出量指数均随年龄显著下降，但男性下降幅度大于女性（单位为ml/m：1组与4组相比：女性为51.76对41.94，p < 0.001；男性为55.31对40.78，p < 0.001）。两性各年龄组之间心室比例（右心室与左心室容积比）保持恒定。
在两性中，健康衰老与向心性增加和心室尺寸减小有关。此外，还观察到了左心室收缩功能方面与年龄相关的显著性别差异。
