Effect of age on diastolic left ventricular filling at rest and during inotropic stimulation and acute systemic hypertension: experimental studies in conscious beagles.
Effect of age on diastolic left ventricular filling at rest and during inotropic stimulation and acute systemic hypertension: experimental studies in conscious beagles.
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年龄对静息时和正性肌力刺激期间舒张左心室充盈以及急性全身性高血压的影响：有意识的比格犬的实验研究。
DOI：
10.1016/0002-8703(90)90162-q
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发表时间：
1990
影响因子：
4.8
通讯作者：
Kerber,RE
中科院分区：
文献类型：
--
作者：
Vandenberg,BF;Kieso,RA;Fox-Eastham,K;Tomanek,RJ;Kerber,RE
当引起心室功能障碍时，使用正性肌力刺激进行“药理学”压力测试可用于检测冠状动脉疾病。然而，由于衰老、心率和负荷条件的影响，异常舒张期充盈可能被掩盖或模仿。我们评估了年龄对没有闭塞性冠状动脉疾病和左心室肥大的年轻（n = 5）和老年（n = 6）纯种比格犬静息时左心室充盈的影响，我们还评估了左心室充盈速度对多巴酚丁胺和去氧肾上腺素反应的年龄相关差异。在基线时以及输注多巴酚丁胺（10至20μg/kg/min）后进行左心室充盈速度的脉冲多普勒超声心动图检查。获得重复基线记录，然后以 5 至 25 μg/kg/min 的剂量静脉注射去氧肾上腺素，直至收缩动脉压比基线增加至少 30 mm Hg。在基线时，多普勒超声心动图显示年轻组和老年组之间的早期（E）速度或速度时间间隔（VTI）以及心房（A）速度或A/E速度比没有显着差异。然而，旧组的 A VTI 和 A/(A + E) VTI 比值显着增加。施用多巴酚丁胺后，两组的 E 速度均未较基线显着增加。两组的 E VTI、A 速度和 A VTI 均显着增加，但组间增加幅度无差异。输注去氧肾上腺素后，旧组的 E VTI 显着下降，但 A/E 速度或 A/(A + E) VTI 比值较基线没有显着变化。此外，各组之间左心室充盈对去氧肾上腺素的反应没有差异。尸检未发现闭塞性冠状动脉疾病或左心室其他解剖异常的证据。因此，在没有左心室肥厚和闭塞性冠状动脉疾病的情况下，单独衰老会增加左心室充盈的心房成分以及心房充盈对左心室总充盈的相对贡献。后负荷或正性肌力的增加并不影响年轻或年老动物心房充盈对总充盈的相对贡献。
“Pharmacologic” stress testing with inotropic stimulation is useful in the detection of coronary artery disease when ventricular dysfunction is provoked. However, abnormal diastolic filling may be masked or mimicked because of the influence of aging, heart rate, and loading conditions. We evaluated age effects on left ventricular filling at rest in young (n= 5) and old (n= 6) purebred beagles that were free of occlusive coronary disease and left ventricular hypertrophy, and we also evaluated age-related differences in left ventricular filling velocities in response to dobutamine and phenylephrine. Pulsed Doppler echocardiography of left ventricular filling velocities was performed at baseline and then after the administration of dobutamine (10 to 20 μg/kg/min) infusion. Repeat baseline recordings were obtained and then phenylephrine was administered intravenously in doses of 5 to 25 μg/kg/min until systolic arterial pressure increased by at least 30 mm Hg above baseline. At baseline, Doppler echocardiography revealed that there were no significant differences in the early (E) velocity or velocity time interval (VTI), and atrial (A) velocity or the A/E velocity ratio between the young and old groups. However, the A VTI and the A/(A + E) VTI ratio were significantly increased in the old group. With dobutamine administration, the E velocity did not significantly increase from baseline in either group. The E VTI, A velocity and A VTI increased significantly in both groups, but the increases were not different between groups. With phenylephrine infusion there was a significant decrease in the E VTI in the old group but neither the A/E velocity or the A/(A + E) VTI ratio significantly changed from baseline. In addition, there were no differences in the response of left ventricular filling to phenylephrine between groups. Postmortem examination showed no evidence of occlusive coronary artery disease or other anatomic abnormalities of the left ventricle. Thus aging alone, in the absence of left ventricular hypertrophy and occlusive coronary artery disease, increased the atrial component of left ventricular filling and the relative contribution of atrial filling to total left ventricular filling. Increases in afterload or inotropy did not affect the relative contribution of atrial filling to total filling in young or old animals.