Department of Clinical Laboratory, The University of Tokyo Hospital.
Department of Cardiovascular Medicine, The University of Tokyo Hospital.
Circ J. 2024 Aug 23;88(9):1461-1471. doi: 10.1253/circj.CJ-24-0031. Epub 2024 Jun 7.
Age-related changes in left ventricular (LV) structure and function lower the threshold for the onset of heart failure with preserved ejection fraction (HFpEF). LV parameters change also with race; however, the racial differences in age-related changes in LV parameters with and without adjustment for body mass index (BMI), heart rate (HR), and blood pressure (BP) remain unclear.
We performed a subanalysis of the World Alliance Society of Echocardiography Normal Values Study, an international cross-sectional study that examined normal echocardiographic values in 15 countries. The age-related changes in 2-dimensional echocardiographic derived parameters including LV size, systolic function, and mass, were compared between healthy Japanese (n=227) and healthy White (n=98) and Black (n=69) American participants. In men, age-related changes in all parameters did not differ significantly among races. However, compared with Japanese women, White American women had a smaller body surface area (BSA)-indexed LV volume, BSA-indexed LV internal dimension at end-systole, BSA-indexed LV stroke volume, and LV mass index to BSA, and a larger LV ejection fraction with age, even after adjusting for BMI, HR, and BP.
Age-related changes in LV structure and function, which are important for the pathophysiology of HFpEF, may differ by race. Therefore, future studies examining echocardiographic reference values for each age group in each race are needed.
左心室(LV)结构和功能随年龄的变化降低了射血分数保留型心力衰竭(HFpEF)的发病阈值。LV 参数也会随种族而变化;然而,在调整体重指数(BMI)、心率(HR)和血压(BP)后,LV 参数随年龄变化的种族差异仍不清楚。
我们对世界超声心动图协会正常数值研究进行了亚组分析,这是一项国际横断面研究,在 15 个国家检查了正常超声心动图数值。比较了健康的日本参与者(n=227)与健康的美国白种人(n=98)和黑种人(n=69)参与者的二维超声心动图衍生参数的年龄相关变化,包括 LV 大小、收缩功能和质量。在男性中,各参数的年龄相关变化在不同种族之间没有显著差异。然而,与日本女性相比,美国白种女性的 BSA 指数 LV 容量、BSA 指数 LV 收缩末期内径、BSA 指数 LV 每搏量和 LV 质量指数/BSA 较小,LV 射血分数随年龄增长而增大,即使在调整 BMI、HR 和 BP 后也是如此。
LV 结构和功能的年龄相关变化可能因种族而异,这对 HFpEF 的病理生理学很重要。因此,需要对每个种族的每个年龄组的超声心动图参考值进行进一步研究。