Mantero A, Gentile F, Gualtierotti C, Azzollini M, Barbier P, Beretta L, Casazza F, Corno R, Giagnoni E, Lippolis A
Department of Cardiology, A. De Gasperis, Ca' Granda Hospital, Niguarda, Milano, Italy.
Eur Heart J. 1995 Jan;16(1):94-105. doi: 10.1093/eurheartj/16.1.94.
Left ventricular diastolic indexes are influenced by several variables. In order to evaluate the relationship of these indexes to age, heart rate, sex and to standard echo parameters, 288 normal subjects aged from 20 to 80 years, divided into six age groups, underwent a two-dimensional colour Doppler examination. Doppler examination was performed from the apical four chamber view to evaluate transmitral flow; isovolumic relaxation time (IVRT) was measured from an apical five chamber view. In order to obtain a sufficient number of subjects for an adequate statistical analysis, seven hospitals were involved in the study. Univariate analysis showed that age influences the peak velocity of the E (r = -0.46) and A waves (r = 0.46), the E/A ratio (peak velocities) (r = -0.69), the A wave integral (r = 0.48) and the E/A integral ratio (r = -0.57), the early and late filling fractions (r = -0.48 and r = 0.51 respectively), and the E wave deceleration (r = -0.43) and deceleration time (r = 0.36). In subjects older than 70 years an inversion of the E/A wave ratio was observed. Multivariate analysis confirmed that age has an important influence on left ventricular diastolic indexes but also demonstrated that heart rate has a significant influence. Sex, ejection fraction (EF), and the dimensions of the mitral annulus and the left ventricular posterior wall had less influence on left ventricular diastolic indexes. The mean values of E and A wave acceleration, deceleration and peak velocity were used to depict left ventricular filling morphology in various age groups for three different heart rate values. The conclusions of the study, are: (1) normal left ventricular diastolic parameters were obtained as mean values at seven different hospitals (2) when evaluating left ventricular diastolic function parameters it is important to take into account age and heart rate; E/A inversion in older subjects should be considered the normal mitral flow pattern.
左心室舒张指标受多种变量影响。为评估这些指标与年龄、心率、性别以及标准超声心动图参数之间的关系，将288名年龄在20至80岁之间的正常受试者分为六个年龄组，进行了二维彩色多普勒检查。从心尖四腔视图进行多普勒检查以评估二尖瓣血流；从心尖五腔视图测量等容舒张时间（IVRT）。为获得足够数量的受试者进行充分的统计分析，七家医院参与了该研究。单因素分析表明，年龄影响E波（r = -0.46）和A波（r = 0.46）的峰值速度、E/A比值（峰值速度）（r = -0.69）、A波积分（r = 0.48）和E/A积分比值（r = -0.57）、早期和晚期充盈分数（分别为r = -0.48和r = 0.51）以及E波减速（r = -0.43）和减速时间（r = 0.36）。在70岁以上的受试者中观察到E/A波比值倒置。多因素分析证实年龄对左心室舒张指标有重要影响，但也表明心率有显著影响。性别、射血分数（EF）以及二尖瓣环和左心室后壁的尺寸对左心室舒张指标的影响较小。使用E波和A波的平均加速度、减速和峰值速度来描绘不同年龄组在三种不同心率值下的左心室充盈形态。该研究的结论是：（1）在七家不同医院获得了正常左心室舒张参数的平均值；（2）在评估左心室舒张功能参数时，考虑年龄和心率很重要；老年受试者中的E/A倒置应被视为正常的二尖瓣血流模式。
