AGE ASSOCIATED CHANGES IN VASCULAR STIFFNESS PROPERTIES

血管硬度特性与年龄相关的变化

• 批准号: 3767790
• 负责人: E LAKATTA
• 金额: --
• 依托单位: NATIONAL INSTITUTE ON AGING
• 依托单位国家: 美国
• 资助国家: 美国
• 起止时间: 至
• 项目状态: 未结题
• 来源: https://reporter.nih.gov/project-details/3767790
• 关键词: African American; aging; arteriosclerosis; artery; blood pressure; body composition; disease /disorder proneness /risk; exercise; female; gender difference; heart dimension /size; human old age (65+); human subject; intracardiac volume; male; myocardium; nuclear magnetic resonance spectroscopy; physical fitness; pulse pressure wave; racial /ethnic difference; stroke; ultrasound blood flow measurement; vascular resistance

In industrialized societies increases in arterial stiffness and left ventricular (LV) mass are considered part of normative aging. However, considerable heterogeneity exists in the age-associated changes in these variables both across cultures as well as within a given population. The ultimate goals of this project are to address the issue of how alterations in arterial stiffness affect the myocardium and whether in outcome studies they relate to vascular insufficiency syndromes, e.g., stroke. We have initiated a pilot study in which measurements of cardiac mass (via NMR), filling properties and isovolumic relaxation time (via Doppler echocardiography), carotid pressure pulse (via applanation tomography) and arterial pulse wave velocity (Doppler sonography) are made in men and women who differ with respect to age, race, arterial pressure, body composition, and physical conditioning status. As expected, results indicate that with increasing age arterial stiffening leads to an increase in pulse wave velocity. This is associated with an early return of reflected pulse waves from peripheral sites which produce an augmented and late occurring peak of carotid pressure pulse. It is important to note that these arterial changes are, by and large, not detected by routine clinical measures of brachial arterial pressure and are independent of gender, but vary inversely with exercise capacity. Of note, also is that in highly physically conditioned older individuals (greater than 60 yrs of age) the arterial stiffness and reflected wave indices are markedly reduced relative to their sedentary age peers and do not differ from those of younger individuals, although the age-associated increase in systolic pressure persists. We have undertaken an initiative to extend many of these studies to Black Americans and to other non-Western populations in which different patterns of arterial pressure change occurs with aging (in China via a research contract (cf. #N01-AG-02-2118)). Long term goals include determination of whether "normative"age-associated changes in cardiac structure (i.e. increasing left ventricular mass) and function (delayed left ventricular relaxation and reduced early diastolic filling rates) are directly related to changes in arterial stiffness. If such is the case, a long-term intervention trial might be justified to see whether amelioration of arterial stiffness by medication or lifestyle intervention can attenuate these age-associated changes in cardiac structure and function and reduce future cardiovascular morbidity.

在工业化社会中，动脉僵硬度增加，左 心室（LV）质量被认为是正常衰老的一部分。 然而， 与年龄相关的变化存在相当大的异质性 这些变量既可以跨文化，也可以在给定的范围内 人口。 该项目的最终目标是解决 动脉硬度的变化如何影响心肌的问题 以及在结果研究中它们是否与血管功能不全有关 综合症，例如中风。 我们已经启动了一项试点研究 测量心脏质量（通过 NMR）、充盈特性和 等容舒张时间（通过多普勒超声心动图），颈动脉 压力脉搏（通过压平断层扫描）和动脉脉搏波 速度（多普勒超声检查）是在男性和女性中进行的，其不同 考虑到年龄、种族、动脉压、身体成分和身体状况 调理状态。 正如预期的那样，结果表明 年龄增长动脉硬化导致脉搏波增加 速度。 这与反射脉冲的早期返回有关 来自外围部位的波产生增强和晚期 颈动脉压力脉冲出现峰值。 重要的是要注意 总的来说，这些动脉变化是常规检测不到的 肱动脉压的临床测量并且独立于 性别，但与运动能力成反比。 值得注意的是，还有 在身体状况良好的老年人中（大于 60 岁）动脉僵硬度和反射波指数为 与久坐的年龄同龄人相比，明显减少，并且不 与年轻人不同，尽管与年龄相关 收缩压持续升高。 我们已经开展了一项 倡议将许多此类研究扩展到美国黑人并 其他非西方人群，其中动脉模式不同 压力随着衰老而变化（在中国通过研究合同 （参见#N01-AG-02-2118））。 长期目标包括确定 心脏结构是否发生“正常”的与年龄相关的变化（即 增加左心室质量）和功能（左心室延迟） 心室舒张和舒张早期充盈率降低） 与动脉僵硬度的变化直接相关。 如果是这样的话 在这种情况下，可能需要进行长期干预试验来看看是否 通过药物或生活方式改善动脉僵硬度 干预可以减轻这些与年龄相关的心脏变化 结构和功能并降低未来心血管发病率。