室间隔老年性改变及其机制探讨

Age-Associated Morphological Changes in Interventricular Septum and Their Possible Mechanism

观测室间隔的老年性改变，探讨其机制及临床意义。方法：取天津市高校健康教师２６３人，分成５个年龄组，行超声心动图检查。结果：（ １）室间隔与主动脉根部夹角与年龄呈负相关（ ｒ＝－ ０． ３０４， Ｐ＜ ０． ０１）。（２）室间隔“乙状形”改变：主动脉与室间隔连接处至心尖的距离（Ｄ）随增龄缩短（ｒ＝－ ０． ２９４， Ｐ＜ ０． ００１）；室间隔至Ｄ线的最大垂直距离与年龄呈正相关（ｒ＝０．１９，Ｐ＜０．０１）。结论：此“乙状形”改变可能与室间隔被长期血流冲击及扩张和伸长的主动脉向下推压室间隔有关。此形变可延长并改变左室射血血流轨迹，增加内摩擦力和射血阻力，从而降低左室射血效率。

To study age--associated morphological changes in the interventricular septum and their possible mechanism and clinical significance. Methods:Two hundred sixty--three normal healthy intellectuals from four Tianjin universities were randomly selected and grouped into five age groups, and each of them received echocardiographic examination, and then the data obtained were analysed statistically. Results: The angle between the aortic root and interventricular septum(IVS) was negatively correlated with age(r =-0. 304, P < 0. 01 ), the regression formula as: Y = 132. 14 -- 0. 305 × age(years). The sigmoid shape of the septum appeared to be prominent with aging; two parameters were designed to quantitate such changes: (1)The distance from the point connecting anterior aortic wall with IVS to the apex(D) was progressively shortening with aging; and negatively correlated with age(r = -0. 304, P< 0. 01). (2)The maximal perpendicular distance from IVS to the D line(Dmax ) correlated positively with age(r = 0. 19, P < 0. 01 ),Conclusion: The study disclosed and quantitated the sigmoid changes in IVS and sharper changes in septoaortic angle with aging. Such changes may be due to: age-related dilation and lengthening of aorta pushing the septum downward, and longstanding blood rushing to the IVS and aortic root. It is logical to suggest that such aging changes are of pathophysiological and clinical significance.