Interaction between body size and cardiac workload - Influence on left ventricular mass during body growth and adulthood
Interaction between body size and cardiac workload - Influence on left ventricular mass during body growth and adulthood
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DOI：
10.1161/01.hyp.31.5.1077
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发表时间：
1998-05-01
期刊：
影响因子：
8.3
通讯作者：
Daniels, SR
中科院分区：
文献类型：
--
作者：
de Simone, G;Devereux, RB;Daniels, SR
左心室的发育与身体的生长是平行的。在婴儿期，身体大小与左心室（LV）质量的关系非常密切。随着年龄的增长，左室质量与体型的变异性明显增加。为了验证左室体积变异性的年龄相关性增加是由于血流动力学刺激对左室生长的进行性影响这一假设，我们对766名年龄从1天到85岁的体重正常、血压正常的个体（330名女性受试者，373名年龄小于18岁的受试者）进行了定量m型超声心动图检测。左室质量与身高呈线性相关（2.7）（r(2)= 0.69）。以体型预测左室质量值在出生时更为准确，随着年龄的增长，其准确性逐渐降低。卒中功（卒中容积乘以收缩压）与左室质量密切相关（r(2)= 0.74）。左室质量的解释方差从与身高（2.7）有关的单变量回归的69%增加到包括身高（2.7）、卒中工作和性别的多变量模型的82%。在儿童和青少年（小于18岁）中，身高（2.7）是左室质量的主要决定因素，而在成年期，卒中工作和性别是比身高（2.7）更重要的左室质量预测因素。因此(1)由于血流动力学负荷的变异性和性别的增加，婴儿早期后身体生长对左室肿块发展的影响减小；(2)青春期后、成年期，在血压正常、体重正常的个体中，血流动力学负荷和男性性别对左室质量的影响大于体型；(3)所研究的模型仍然无法解释相当大比例的左室质量变异性。这可能是由于基因型变异和/或测量误差。
The development of the left ventricle parallels body growth. During infancy, the relation between body size and left ventricular (LV) mass is very close. With advancing age, variability of LV mass in relation to body size markedly increases. To test the hypothesis that the age-related increase in variability of LV mass is due to the progressive impact of hemodynamic stimuli on LV growth, quantitative M-mode echocardiograms were obtained in 766 normal-weight, normotensive individuals over a range of ages from 1 day to 85 years (330 female subjects, 373 subjects younger than 18 years). LV mass was linearly related to height(2.7) (r(2)=.69). Prediction of values of LV mass by body size was more accurate at birth and progressively less precise with increasing age. Stroke work (stroke volume times systolic pressure) was closely related to LV mass (r(2)=.74). The explained variance of LV mass increased from 69% in the univariate regression with height(2.7) to 82% in a multivariate model including height(2.7), stroke work, and gender. In children and adolescents (younger than 18 years), height(2.7) was the main determinant of LV mass, whereas during adulthood stroke work and gender were more important predictors of LV mass than height(2.7). Thus (1) the influence of body growth on development of LV mass decreases after early infancy because of both the variability of hemodynamic load and the increasing effect of gender; (2) after adolescence, during adulthood, in normotensive, normal-weight individuals, the impact of hemodynamic load and male gender on LV mass is greater than the one of body size; and (3) an appreciable proportion of variability of LV mass remains unexplained with the studied models. This might be due to genotypic variations and/or measurement error.