年龄对心血管僵硬度的影响

Analysis of age related cardio-vascular stiffening

目的分析年龄因素对心血管僵硬度的影响。方法将447名接受体检者分成6个年龄组,分别行超声心动图检查,测量舒张末期室间隔厚度(IVSd)和左心室后壁厚度(LVPWd),左心室舒张期内经(LVIDd)和收缩期内径(LVIDs);测量、计算心功能参数:Tei指数,二尖瓣口舒张早、晚期血流速度峰值比(E/A),二尖瓣环舒张早、晚期速度峰值比(e/a),二尖瓣舒张早期血流及瓣环速度峰值比(E/e),射血分数(EF);检测动脉僵硬度参数:心踝血管指数(CAVI)和颈-股脉搏波速度(CFPWV)。对各年龄组进行组间比较和相关分析。结果 IVSd及LVPWd随年龄增加而增厚,差异有统计学意义(P均<0.001);Tei指数、E/A、e/a、E/e随年龄增加而变化,差异有统计学意义(P均<0.05);动脉僵硬参数CAVI和CFPWV随年龄增加而增大(P均<0.001)。动脉僵硬参数CAVI和CFPWV与心脏Tei指数、E/A、e/a、E/e显著相关(P均<0.05);控制年龄偏相关分析显示CAVI与Tei指数、CFPWV与E/A显著相关(P<0.001)。结论年龄是动脉、心脏僵硬度增加的重要影响因素,心脏与血管僵硬度相互影响。

Objective To analyze the changes of cardiovascular function and structure with the increase of aging. Methods Four hundred and forty-seven people were assigned into 6 groups based on age. The interventricular septal thickness at end diastole （IVSd）, left ventrieular posterior wall thickness at end diastole （LVPWd）, left ventricular internal dimension at end diastole （LVIDd） and left ventricular internal dimension at end systole （LVIDs） were measured. The parameters of cardiac function, including Tel index, the ratio of early to late peak mitral diastolic flow （E/A）, the ratio of early to late diastolic mitral annular velocities （e/a）, the ratio of early mitral diastolic flow to mitral annular velocity （E/e）, ejection fraction （EF） were calculated and compared. The indictors of arterial stiffness, including cardiac-ankle vascular index （CAVI） and carotid-to-femoral pulse wave velocity （CFPWV） were measured and compared, respectively. Results With the increase of aging, IVSd and LVPWd became thicker （all P〈0. 001）, Tel index, E/A, e/a and E/e changed （all P〈0.05）, while CAVI and CFPWV increased （all P〈0. 001）. CAVI correlated with Tel index, E/A, e/a, E/e, while CFPWV associated with Tel index, E/A, e/a, E/e, respectively （all P〈0.05）. Tel index correlated with CAVI, while E/A related with CFPWV （P〈0. 001） after adjusting age. Conclusion Advancing age contributes to cardio-vascular stiffening, and they influence each other.