Manca C, Aschieri D, Piazza A, Conti M, Barilli A L, Tiberti G, Bolognesi R, Cavatorta A, Borghetti A
Cattedra di Cardiologia, Università di Parma, Italy.
Int J Cardiol. 1995 Feb;48(2):121-9. doi: 10.1016/0167-5273(94)02225-8.
The aim of this study was to evaluate the influence of age and other clinical and echocardiographic parameters on left ventricular filling in a group of 174 untreated patients with mild to moderate hypertension (aged 20-82 years; mean 51.2 years) and in 189 age-matched normotensive subjects. All subjects underwent an echocardiographic study with pulsed Doppler evaluation of left ventricular filling. Left ventricular dimensions and indexes of systolic function were similar and within normal limits in both groups. Left ventricular filling was altered in hypertensive subjects < 65 years with a decrease of peak early velocity (peak E), an increase of peak atrial velocity (peak A) and a reduced E/A ratio. However in subjects > or = 65 years, we did not observe any differences in transmitral flow velocity pattern between hypertensive and normotensive subjects. The stepwise regression analysis showed that age alone explains up to 8% of peak E variance, 14% of peak A and 26% of E/A ratio in hypertensives, while in normotensives it explains up to 18% of peak E variance, 50% of peak A and 61% of E/A ratio. The other variables entered into the regression slightly improved the predictive power. In conclusion, age is the major independent factor affecting left ventricular filling in both groups, even if its predictive power was smaller in the hypertensive group. The similarity of diastolic filling pattern in elderly hypertensive and normotensive subjects suggests that the 'aging factor' plays an important role in influencing left ventricular filling pattern so as to mask the effect of hypertension in the elderly patients.
本研究旨在评估年龄以及其他临床和超声心动图参数对一组174例未经治疗的轻至中度高血压患者（年龄20 - 82岁；平均51.2岁）和189例年龄匹配的血压正常受试者左心室充盈的影响。所有受试者均接受了超声心动图检查，并采用脉冲多普勒评估左心室充盈情况。两组的左心室尺寸和收缩功能指标相似且均在正常范围内。年龄小于65岁的高血压患者左心室充盈发生改变，表现为早期峰值速度（E峰）降低、心房峰值速度（A峰）增加以及E/A比值降低。然而，在年龄大于或等于65岁的受试者中，我们未观察到高血压患者与血压正常受试者之间二尖瓣血流速度模式存在任何差异。逐步回归分析显示，仅年龄一项在高血压患者中可解释高达8%的E峰方差、14%的A峰以及26%的E/A比值变化，而在血压正常者中可解释高达18%的E峰方差、50%的A峰以及61%的E/A比值变化。纳入回归分析的其他变量仅略微提高了预测能力。总之，年龄是影响两组左心室充盈的主要独立因素，尽管其在高血压组中的预测能力较小。老年高血压患者与血压正常受试者舒张期充盈模式的相似性表明，“衰老因素”在影响左心室充盈模式方面起重要作用，从而掩盖了高血压对老年患者的影响。
