心肌局部运动增龄变化的组织多普勒超声改变及影响因素研究

Study on the changes of regional left ventricular function with aging in normal subjects by Doppler tissue imaging

目的探讨心肌局部运动的增龄变化及超声多普勒组织成像改变规律。方法按年龄将112名健康人分为4组:青少年组(≤18岁)24名;青年组(18～39岁)30名;中年组(40～59岁) 29名;老年组(≥60岁)29名。应用定量组织多普勒技术观察各组左心室各节段心肌收缩期峰值速度(Vs)、舒张早期峰值速度(Ve)、心房收缩期峰值速度(Va)和Ve／Va比值,并分析不同年龄组心肌局部运动的特点及其影响因素。结果同一室壁各节段心肌运动速度显著不同,由二尖瓣环水平、基底段、中部到远端运动速度逐渐减低。不同室壁心肌运动速度不同,侧壁、后壁、前壁、下壁较高[环部Ve分别为(9．85±3．02)、(9．80±3．09)、(8．86±3．16)、(8．23±2．48)cm／s],前后间隔最低[环部Ve分别为(6．89±2．60)、(7．94±2．64)cm／s]。各节段心肌运动速度与性别无关,与年龄、ST段时值均数、体质指数、心率相关,其中与年龄的相关性最好。结论左心室各节段心肌收缩及舒张速度呈现规律性的变化,年龄为影响各节段心肌收缩、舒张运动速度的主要因素,各节段心肌舒张功能的增龄性改变更明显。

Objective To evaluate the changes of left ventricular regional function in normal subjects with aging and the influencing factors by Doppler tissue imaging. Methods One hundred and twelve normal subjects were divided into four groups according to age： Ⅰ group with age≤18 years old ;Ⅱ group with 18〈age≤40 years old; Ⅲgroup with 40〈age≤60 years old;Ⅳ group with age〉60 years old. Using a quantitative tissue velocity analysis system and tissue tracking, the peak velocities of different ventricular segments at systole, early and late diastole （Vs,Ve,Va） , the Ve/Va ratios were obtained and the effects of age, gender, heart rate and STd were analyzed. Results （1） Peak velocities of different segments of each wall were decreased one by one from mitral annulus, the basal, middle segment to the apical portion. （2） Peak velocities of different ventricular walls were significantly different, with the antero- and posterio-inter-ventricular septum being the lowest [Ve （6.89 ± 2.60）, （7.94 ±2.64） cm/s] and with the latero-, posterio-, antero, and inferior walls of the left ventricle being higher[Ve （9.85 ± 3.02）, （9.80± 3.09）, （8.86 ± 3. 16）, （8.23 ± 2.48）cm/s]. （3） Peak velocities of different segments were associated with age, STd, BMI, heart rate and not associated with gender. （4） The Ve/Va ratios were increased one by one from mitral annulus, basal, middle segment to apical portion, and were significantly lower in Ⅲ group and Ⅳ group than in Ⅰ group and Ⅱ group. Conclusions Peak velocities of different segments at different walls change regularly and age is the most important influencing factor to the diastolic velocities.