Harada K, Suzuki T, Shimada K, Takada G
Department of Pediatrics, Akita University School of Medicine, Hondo, Japan.
Int J Cardiol. 1998 Jan 5;63(1):9-14. doi: 10.1016/s0167-5273(97)00269-6.
Age-related changes in left ventricular diastolic filling have been reported to occur in normal children in studies using Doppler echocardiographic methods. However, little information currently exists on the relationships between transmitral flow velocity patterns and the left ventricular mass. We measured left ventricular end-diastolic volume, left ventricular mass, mass/volume ratio, and transmitral flow velocity patterns by M-mode and Doppler echocardiography in 165 normal children aged 5 days to 195 months. Subjects were divided into 6 age groups: <1; 1 to <3; 3 to <5; 5 to <7; 7 to <9; and > or = 9 years old. The left ventricular end-diastolic volume and mass increased progressively with increasing age. However, the mass/volume ratio in infants <1 year was significantly higher than that in infants 1 to <3 years (1.32+/-0.25 vs. 1.14+/-0.16, p<0.01) without any changes of the ratio thereafter. The peak E wave in infants <1 year was significantly lower than that in 1 to <3 years (71+/-18 vs. 92+/-13 cm/s, p<0.01) without changes thereafter. As the flow velocity time integral of E wave increased and that of A wave remained constant, the flow velocity time integral of E/A wave increased with increasing age. The early diastolic tilling fraction in infants <1 year was lower than that in infants 1 to 3 years. (0.61+/-0.07 vs. 0.70+/-0.06, p<0.01). The atrial filling fraction in infants <1 year was higher than that in infants 1 to <3 years (0.40+/-0.08 vs. 0.30+/-0.06, p<0.01) with a little decrease thereafter. The peak E wave, early diastolic tilling fraction, and the atrial filling fraction correlated with the logarithm of age (p<0.01). Age-related changes in these Doppler echocardiographic findings suggest reduced left ventricular early diastolic filling patterns. The mass/volume ratio correlated linearly with peak E wave, early diastolic filling fraction, and atrial filling fraction (r=-0.38, -0.33, and 0.26, p<0.01). No significant relationships between mass/volume ratio and the other Doppler indices were found. Thus, the age-related reduction in the mass/volume ratio may be one of the mechanisms underlying age-related changes in the early diastolic ventricular filling as assessed by Doppler echocardiography.
据报道，在使用多普勒超声心动图方法的研究中，正常儿童存在与年龄相关的左心室舒张期充盈变化。然而，目前关于二尖瓣血流速度模式与左心室质量之间的关系的信息很少。我们通过M型和多普勒超声心动图测量了165名年龄在5天至195个月的正常儿童的左心室舒张末期容积、左心室质量、质量/容积比以及二尖瓣血流速度模式。受试者被分为6个年龄组：<1岁；1至<3岁；3至<5岁；5至<7岁；7至<9岁；以及≥9岁。左心室舒张末期容积和质量随年龄增长而逐渐增加。然而，<1岁婴儿的质量/容积比显著高于1至<3岁的婴儿（1.32±0.25对1.14±0.16，p<0.01），此后该比值没有变化。<1岁婴儿的E波峰值显著低于1至<3岁的婴儿（71±18对92±13cm/s，p<0.01），此后没有变化。随着E波流速时间积分增加而A波流速时间积分保持不变，E/A波流速时间积分随年龄增长而增加。<1岁婴儿的舒张早期充盈分数低于1至3岁的婴儿（0.61±0.07对0.70±0.06，p<0.01）。<1岁婴儿的心房充盈分数高于1至<3岁的婴儿（0.40±0.08对0.30±0.06，p<0.01），此后略有下降。E波峰值舒张早期充盈分数和心房充盈分数与年龄的对数相关（p<0.01）。这些多普勒超声心动图结果中与年龄相关的变化表明左心室舒张早期充盈模式降低。质量/容积比与E波峰值、舒张早期充盈分数和心房充盈分数呈线性相关（r=-0.38、-0.33和0.26，p<0.01）。未发现质量/容积比与其他多普勒指标之间存在显著关系。因此，质量/容积比与年龄相关的降低可能是多普勒超声心动图评估的舒张早期心室充盈与年龄相关变化的潜在机制之一。
