超声心动图观察年龄、性别及心率等因素对心动周期各时相的影响

Effects of Age, Sex and Heart Rate Alterations on Systolic and Diastolic Timing Intervals During Cardiac Cycle in Normal Subjects: A Combined M-Mode and Doppler Echocardiographic Study

应用Ｍ型及脉冲多普勒超声心动图观察了３０５例不同年龄、性别及心率健康人的心动周期各时间间期，并对其中３６例健康志愿者作了食管心房调搏超声心动图负荷试验。发现随年龄增长，等容舒张期、Ａ＿２Ｅ间期及心房收缩期延长（ｒ＝０．９４６、０．８３５及０．８７５，Ｐ均＜０．０１），缓慢充盈期缩短（ｒ＝－０．７０３．Ｐ＜０．０５），舒张充盈期在心动周期中所占比值减小（ｒ＝－０．８１２．Ｐ＜０．０１）。同时发现随心率加快，快速充盈期及心房收缩期在舒张充盈期中所占比值逐渐加大至融合，缓慢充盈期所占比值逐渐减小至消失。并发现随心率加快，射血前期、射血期及Ａ２Ｅ间期在心动周期中所占比值加大（ｒ＝０．９７０、０．９６３及０．８７４，Ｐ均＜０．０１）。舒张充盈期所占比值减少（ｒ＝－０．８４９，Ｐ＜０．００１）。性别因素对心动周期各时相无影响。提示不可忽视年龄及心率对心动周期各时相的影响。

To investigate the effects of age, sex and heart rate alterations on systolic and diastolic timing intervals , M-mode and Doppler echocardiography were performed in 160 healthy volunteers aged 21 to 97 years ,and 36 of them were paced from the right atrium steady to 90 , 120 and 160 bearts per minute(BPM). It was found that age-related hemodynamic changes during diastole are characterized by a prolongation of isovolumetric relaxation time (IVRT),A2E interval and atrial filling period(AFP)(r=0. 946, 0.835 and 0. 875, P all <0.01) , decreased slow filling period(SFP) and the lesser proportion of diastolic filling period (DFP) in the cycle length(r=-0.703 and -0. 812 , P<0. 05 and 0. 01 ). It was also found that with increased heart rate, pre-ejection period (PEP), left ventricular ejection time (LVET) and A2E interval became an increasingly greater proportion of cycle length (r=0. 970,0. 963 and 0. 874 , P all <0. 01), while DFP occupied a lesser proportion of the cycle length (r=-0. 849 , P<0. 01); Rapid filling period (RFP)and AFP occupied a greater proportion and SFP occupied a lesser proportion of the DEP.With further increase in heart rate ,merging of the RFP and AFP occurs. There were no significant differences between men and women in systolic or diastolic timing intervals.These findings suggested that age and heart rate-related physiologic changes should be taken into consideration when evaluating systolic and diastolic timing intervals.