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正常血压人群从出生到成熟过程中总动脉顺应性的年龄相关变化。

Age-related changes in total arterial capacitance from birth to maturity in a normotensive population.

作者信息

de Simone G, Roman M J, Daniels S R, Mureddu G, Kimball T R, Greco R, Devereux R B

机构信息

Division of Cardiology, New York Hospital-Cornell Medical Center, New York 10021, USA.

出版信息

Hypertension. 1997 Jun;29(6):1213-7. doi: 10.1161/01.hyp.29.6.1213.

Abstract

We evaluated the effect of body growth and aging on the ratio of echocardiographic (Teichholz) stroke volume to pulse pressure (SV/PP ratio) in 373 normal-weight, normotensive children to adolescents (1 day to 17 years old; 166 girls, 87 nonwhite) and 393 normal adults (17 to 85 years old; 164 women, 112 nonwhite). Stroke volume increased with age in children (r = .64, P < .0001) and was stable in adults; pulse pressure decreased slightly with age in children (r = -.10, P = .06) and increased in adults (r = .29, P < .0001). As a consequence, SV/PP ratio increased with age in children (r = .51, P < .0001) and decreased in adults (r = -.18, P = .0004). To control for changes in body size that influence the size of the arterial tree, we used ANCOVA to adjust SV/PP for body size. Body size-adjusted SV/PP ratio was no longer related to age in children, whereas the negative relation with aging in adults remained statistically significant (r = -.19, P < .0002). Heart rate was negatively related to SV/PP ratio in both children and adolescents and adults, but this relation did not influence the relation with age. In multivariate analysis, high SV/PP ratio was predicted by greater height (P < .002) and weight (P < .04) and nonwhite race (P < .001) in children and adolescents and by younger age (P < .0001), greater weight (P < .0001), and low heart rate (P < .001) in adults. Sex did not enter the regression models. Thus, (1) SV/PP ratio is a measure of increasing capacity of the arterial tree during growth, whereas it depends on arterial compliance during adulthood through old age; (2) arterial compliance decreases progressively with aging; (3) the apparent difference between males and females might be due to their different body sizes.

摘要

我们评估了身体生长和衰老对373名体重正常、血压正常的儿童至青少年(1天至17岁;166名女孩,87名非白人)以及393名正常成年人(17至85岁;164名女性,112名非白人)超声心动图(Teichholz法)每搏输出量与脉压之比(SV/PP比值)的影响。儿童的每搏输出量随年龄增加(r = 0.64,P < 0.0001),而成年人的则稳定;儿童的脉压随年龄略有下降(r = -0.10,P = 0.06),成年人的则增加(r = 0.29,P < 0.0001)。因此,儿童的SV/PP比值随年龄增加(r = 0.51,P < 0.0001),成年人的则下降(r = -0.18,P = 0.0004)。为了控制影响动脉树大小的身体大小变化,我们使用协方差分析来调整SV/PP以考虑身体大小。调整身体大小后的SV/PP比值在儿童中不再与年龄相关,而在成年人中与衰老的负相关在统计学上仍然显著(r = -0.19,P < 0.0002)。心率在儿童、青少年和成年人中均与SV/PP比值呈负相关,但这种关系并不影响与年龄的关系。在多变量分析中,儿童和青少年中较高的SV/PP比值可由身高较高(P < 0.002)、体重较重(P < 0.04)和非白人种族(P < 0.001)预测,成年人中则可由年龄较小(P < 0.0001)、体重较重(P < 0.0001)和心率较低(P < 0.001)预测。性别未进入回归模型。因此,(1)SV/PP比值是生长期间动脉树容量增加的一种度量,而在成年期至老年期它取决于动脉顺应性;(2)动脉顺应性随衰老而逐渐降低;(3)男性和女性之间的明显差异可能是由于他们不同的身体大小。

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