Klein A L, Abdalla I, Murray R D, Lee J C, Vandervoort P, Thomas J D, Appleton C P, Tajik A J
Department of Cardiology, The Cleveland Clinic Foundation, Ohio 44195, USA.
J Am Soc Echocardiogr. 1998 May;11(5):458-65. doi: 10.1016/s0894-7317(98)70026-4.
Aging influences pulmonary venous flow and mitral inflow velocities. The duration of pulmonary venous atrial reversal flow exceeds that of the mitral inflow A wave in patients with left ventricular end-diastolic pressures greater than 15 mm Hg. The objective of this study was to investigate the effect of age on the difference between the duration of pulmonary venous atrial reversal flow and that of the mitral inflow A wave in a large number of normal individuals. Pulsed wave Doppler transthoracic echocardiograms of the pulmonary venous flow and the transmitral inflow with respiratory monitoring were made of 72 normal volunteers (40 women) ranging in age between 23 and 84 years. The differences in the durations of pulmonary venous atrial reversal flow and mitral inflow A wave were measured and their correlation with age assessed. Age was not highly correlated with the duration of pulmonary venous atrial reversal flow (r = 0.25) nor the duration of the mitral inflow A wave (r = 0.33). The duration of pulmonary venous atrial reversal flow exceeded the duration of the mitral inflow A-wave flow only in three (4%) of 72 subjects, and age was not related to the index in this group (r = -0.16; p = 0.19). The difference in durations was not significantly affected by the phase of respiration. Men had higher values on all measurements than women. The difference between the pulmonary venous atrial reversal duration and the mitral inflow A-wave duration is independent of age and thus may be used as a reliable index of left ventricular end-diastolic pressure, even in elderly patients.
衰老会影响肺静脉血流和二尖瓣流入速度。在左心室舒张末期压力大于15 mmHg的患者中，肺静脉心房逆向血流的持续时间超过二尖瓣流入A波的持续时间。本研究的目的是在大量正常个体中研究年龄对肺静脉心房逆向血流持续时间与二尖瓣流入A波持续时间之差的影响。对72名年龄在23至84岁之间的正常志愿者（40名女性）进行了经胸超声心动图检查，采用脉冲波多普勒测量肺静脉血流和二尖瓣流入血流，并进行呼吸监测。测量肺静脉心房逆向血流和二尖瓣流入A波的持续时间差异，并评估其与年龄的相关性。年龄与肺静脉心房逆向血流持续时间（r = 0.25）和二尖瓣流入A波持续时间（r = 0.33）均无高度相关性。在72名受试者中，只有3名（4%）的肺静脉心房逆向血流持续时间超过二尖瓣流入A波血流持续时间，且年龄与该组的该指标无关（r = -0.16；p = 0.19）。持续时间的差异不受呼吸阶段的显著影响。男性在所有测量值上均高于女性。肺静脉心房逆向持续时间与二尖瓣流入A波持续时间之差与年龄无关，因此即使在老年患者中也可作为左心室舒张末期压力的可靠指标。
