ABSTRACT

Background: The impact of age on the association between central aortic hemodynamics and left ventricular (LV) remodeling has not been well elucidated. We compared the relationship between measurements of central blood pressure (CBP) and LV mass index (LVMI) according to their ages (<50 years versus ≥50 years). Methods: A total of 305 consecutive subjects (64.4 ± 10.9 years, 60.7% males) who underwent invasive coronary angiography (ICA) for the evaluation of coronary artery disease were prospectively enrolled. Just before ICA, CBP was measured at the aortic root using a pig-tail catheter, and CBP indices, including aortic systolic blood pressure (aSBP), aortic pulse pressure (aPP), aortic fractional pulse pressure (=aPP/mean aortic pressure), and aortic pulsatility index (=aPP/diastolic aortic pressure), were recorded. All subjects underwent transthoracic echocardiography, and LVMI was measured on the same day of ICA. Results: In simple linear correlation analyses, LVMI was associated with all CBP indices in subjects aged <50 years (n = 29) (P < .05 for each), but not in those aged ≥50 years (n = 276) (P > .05 for each). In the younger age group (≤50 years), multivariable analysis showed that aSBP (β = 0.457, P= .021) and aPP (β = 0.610, P= .006) had a significant association with LVMI after adjusting for possible confounding factors. The results remained consistent even when analyzed in a 1:1 propensity score-matched cohort. In conclusion, invasively measured aPP showed the closest association with LVMI in subjects aged <50 years, but not those aged ≥50 years. Conclusion: Aortic pulsatile hemodynamic status appears to have a greater effect on LV remodeling in younger people than in older people.

摘要

背景：年龄对中心主动脉血流动力学和左心室 (LV) 重构之间关联的影响尚未得到很好的阐明。我们根据年龄（<50 岁与 50 岁以上）比较了中心血压 (CBP) 和 LV 质量指数 (LVMI) 测量值之间的关系。方法：共有 305 名连续受试者（64.4 ± 10.9 岁，60.7% 男性）接受了侵入性冠状动脉造影 (ICA) 以评估冠状动脉疾病。就在 ICA 之前，使用猪尾导管在主动脉根部测量 CBP，以及 CBP 指数，包括主动脉收缩压 (aSBP)、主动脉脉压 (aPP)、主动脉脉压分数 (=aPP/平均主动脉压)和主动脉搏动指数（=aPP/舒张主动脉压），被记录下来。所有受试者都接受了经胸超声心动图检查，并在 ICA 的同一天测量了 LVMI。结果：在简单的线性相关分析中，LVMI 与 <50 岁（n = 29）受试者的所有 CBP 指数相关（P< .05 每个），但不是在 50 岁以上的人中（n = 276）（每个P > .05）。在年轻年龄组（≤50 岁）中，多变量分析显示，调整可能的混杂因素后，aSBP（β  = 0.457，P = .021）和 aPP（β  = 0.610，P = .006）与 LVMI 显着相关. 即使在 1:1 倾向得分匹配的队列中进行分析时，结果也保持一致。总之，有创测量的 aPP 与 <50 岁受试者的 LVMI 相关性最密切，但与年龄≥50 岁的受试者无关。结论：与老年人相比，主动脉搏动血流动力学状态似乎对年轻人的 LV 重构具有更大的影响。