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[衰老对人体左心室-动脉耦合的影响]

[Effects of aging on left ventricle-arterial coupling in man].

作者信息

Cohen-Solal A, Dahan M, Guiomard A, Baleynaud S, Laperche T, Himbert D, Gourgon R

机构信息

Service de cardiologie, hôpital Beaujon, Clichy.

出版信息

Arch Mal Coeur Vaiss. 1993 Aug;86(8):1095-7.

PMID:8129507
Abstract

Twenty-five normotensive men without any cardiac or arterial pathology, aged 22 to 68 years, 12 less than 45 year old, 13 over 45 years, underwent cardiac catheterisation and angiography. The following parameters were calculated: 1) a global index of arterial function (Ea) and its determining factors (Ea = LVESP/SV where LEVSP = left ventricular end systolic pressure and SV = left ventricular stroke volume); Ea = (HR x SVR) + Ea' where HR = heart rate, SVR = total systemic vascular resistance and Ea' = (LVESP - MAP/SV) (MAP = mean arterial pressure); 2) an index of global left ventricular pump function: ELV (ELV = LVESP/LVESV, where LVEDV = left ventricular end systolic volume; 3) an index of LV-arterial coupling: the Ea/ELV ratio. With aging, both Ea (by increase in SVR) and Ea' and ELV increased significantly. Ea/ELV (inverse of the ejection fraction-1) increased with age but ELV less than Ea. Ea/ELV was significantly higher in patients over 45 years of age but the correlation between ejection fraction and age was not statistically significant (p = 0.10). These results suggest that with aging, the improvement in LV pump function approximately corresponds to the degradation in arterial transport function: the left ventricular-arterial coupling as assessed by the Ea/ELV ratio (and therefore the ejection fraction) is maintained in the majority of cases.

摘要

25名血压正常、无任何心脏或动脉病变的男性,年龄在22至68岁之间,其中12名年龄小于45岁,13名年龄大于45岁,接受了心导管插入术和血管造影。计算了以下参数:1)动脉功能的整体指数(Ea)及其决定因素(Ea = LVESP/SV,其中LVESP = 左心室收缩末期压力,SV = 左心室每搏输出量);Ea = (HR x SVR) + Ea',其中HR = 心率,SVR = 总全身血管阻力,Ea' = (LVESP - MAP/SV)(MAP = 平均动脉压);2)左心室整体泵功能指数:ELV(ELV = LVESP/LVESV,其中LVEDV = 左心室舒张末期容积);3)左心室 - 动脉耦合指数:Ea/ELV比值。随着年龄增长,Ea(通过SVR增加)、Ea'和ELV均显著增加。Ea/ELV(射血分数 -1的倒数)随年龄增加,但ELV的增加小于Ea。45岁以上患者的Ea/ELV显著更高,但射血分数与年龄之间的相关性无统计学意义(p = 0.10)。这些结果表明,随着年龄增长,左心室泵功能的改善大致对应于动脉运输功能的退化:通过Ea/ELV比值评估的左心室 - 动脉耦合(以及因此的射血分数)在大多数情况下得以维持。

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