Galderisi M, Benjamin E J, Evans J C, D'Agostino R B, Fuller D L, Lehman B, Levy D
Framingham Heart Study, Massachusetts 01701.
Am J Cardiol. 1993 Nov 15;72(15):1183-7. doi: 10.1016/0002-9149(93)90991-k.
The relations of heart rate and PR interval to Doppler-derived diastolic indexes were examined in 260 men (mean age 75 years) and 462 women (mean age 76 years) from the Framingham Heart Study. Subjects receiving any antihypertensive or cardiac medications were excluded from eligibility; those with mitral stenosis or prosthesis, pacemaker, atrial fibrillation, arrhythmia, left bundle branch block, congestive heart failure, previous myocardial infarction, and technically inadequate Doppler study were also excluded. Peak velocity of early (E) and late (A) diastolic left ventricular (LV) filling, ratio of peak velocities E/A, ratio of time velocity integrals E/A, and atrial filling fraction were studied by multivariable analyses adjusting for age, sex, blood pressure, heart rate and PR interval. Heart rate was a major determinant of all 5 Doppler indexes of diastolic filling; heart rate was inversely associated with peak velocity E, E/A, and time velocity integral E/A, and was directly associated with peak velocity A and atrial filling fraction. PR interval was inversely associated with time velocity integral E/A (p < 0.01) and directly associated with atrial filling fraction. The results were largely unaltered after further adjustment for LV wall thickness, LV end-diastolic diameter and left atrial diameter (in addition to age, sex and blood pressure). Heart rate and PR interval are independent contributors to Doppler-assessed LV diastolic filling in the elderly. The atrial contribution to LV filling depends on its timing in the cardiac cycle and on heart rate. Failure to account for heart rate and PR interval may lead to inappropriate assessment of Doppler diastolic filling.
在弗雷明汉心脏研究中，对260名男性（平均年龄75岁）和462名女性（平均年龄76岁）的心率和PR间期与多普勒衍生舒张指标的关系进行了研究。接受任何抗高血压或心脏药物治疗的受试者被排除在外；患有二尖瓣狭窄或人工瓣膜、起搏器、心房颤动、心律失常、左束支传导阻滞、充血性心力衰竭、既往心肌梗死以及多普勒研究技术不充分的受试者也被排除。通过对年龄、性别、血压、心率和PR间期进行多变量分析，研究了舒张早期（E）和晚期（A）左心室（LV）充盈的峰值速度、峰值速度E/A比值、时间速度积分E/A比值以及心房充盈分数。心率是所有5个舒张期充盈多普勒指标的主要决定因素；心率与峰值速度E、E/A以及时间速度积分E/A呈负相关，与峰值速度A和心房充盈分数呈正相关。PR间期与时间速度积分E/A呈负相关（p<0.01），与心房充盈分数呈正相关。在进一步调整左心室壁厚度、左心室舒张末期直径和左心房直径（除年龄、性别和血压外）后，结果基本未改变。心率和PR间期是老年人多普勒评估左心室舒张期充盈的独立影响因素。心房对左心室充盈的贡献取决于其在心动周期中的时间以及心率。未考虑心率和PR间期可能导致对多普勒舒张期充盈的评估不当。
