Supplemental Digital Content is available in the text. The relative contribution of loading conditions at different ages across the full adult lifespan to decreases in left ventricular (LV) diastolic function is unclear. Using central arterial pressure and aortic velocity and diameter measurements in the outflow tract, we determined the contribution of systemic vascular resistance, compression wave pressures (characteristic impedance [Zc]×aortic flow [Q], [PQ×Zc]) and backward wave pressures (Pb) to LV diastolic function (echocardiography) in a community sample across the full adult lifespan (n=605). Starting from early adulthood, stepwise age-related increases in LV filling pressures (E/e’) and decreases in myocardial relaxation (e’) were noted (P<0.0001). Before 50 years of age, before when PQ×Zc positively correlates with age, Pb, but not systemic vascular resistance was independently associated with LV mass index (P<0.002), E/e’ (P<0.002), and e’ (P<0.05). Moreover, in those over 50 years of age, when PQ×Zc positively correlates with age, again Pb, but neither PQxZc nor systemic vascular resistance was independently associated with LV mass index (P<0.01), E/e’ (P<0.001), and e’ (P<0.001). The contribution of Pb to age-related decreases in LV diastolic function was as strong in those younger as compared with older than 50 years of age and poorly indexed by brachial BP. In conclusion, a striking age-related deterioration in LV diastolic function begins at an early adult age and Pb is the dominant hemodynamic factor that accounts for this relationship. Age-related increases in Pb in young adults contribute as much to functional abnormalities ultimately responsible for LV diastolic dysfunction in hypertension as at an older age, effects poorly indexed by brachial BP.

中文翻译：

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整个成人年龄范围内年龄与左心室舒张功能关系的血流动力学决定因素

补充数字内容在文本中可用。成人整个生命周期中不同年龄的负荷条件对左心室 (LV) 舒张功能下降的相对贡献尚不清楚。使用流出道中的中心动脉压和主动脉速度和直径测量值，我们确定了全身血管阻力、压缩波压力（特征阻抗 [Zc] × 主动脉血流 [Q]、[PQ × Zc]）和反向波压力的贡献（Pb）到整个成人寿命（n = 605）社区样本中的 LV 舒张功能（超声心动图）。从成年早期开始，LV 充盈压 (E/e') 和心肌舒张 (e') 的逐步年龄相关性增加被注意到 (P<0.0001)。在 50 岁之前，当 PQ×Zc 与年龄呈正相关时，Pb、但不是全身血管阻力与 LV 质量指数 (P<0.002)、E/e' (P<0.002) 和 e' (P<0.05) 独立相关。此外，在 50 岁以上的人群中，当 PQ×Zc 与年龄呈正相关时，同样是 Pb，但 PQxZc 和全身血管阻力均不与 LV 质量指数（P<0.01）、E/e'（P<0.001）独立相关) 和 e' (P<0.001)。与年龄超过 50 岁的年轻人相比，Pb 对 LV 舒张功能随年龄相关的下降的贡献同样强烈，而且肱动脉血压指数较差。总之，与年龄相关的 LV 舒张功能显着恶化始于成年早期，而铅是解释这种关系的主要血流动力学因素。