正常人群年龄进程中心脏结构和功能的变化特点

目的 应用超声心动图探讨正常中国人的心脏结构及左心室功能.方法 对15 692名正常中国人进行超声心动图检查,分别测量心脏结构、瓣口血流速度及心脏功能.5岁以上受试者按5岁为一年龄段分为17组,0～5岁受试者分为3组:婴儿组(<1岁)、幼儿组(1～3岁)和小儿组(4～5岁).按心脏结构及心功能各项指标对年龄进行聚类分析.结果 按心脏结构各项指标对年龄进行聚类分析,分为6类:<1岁、1～3岁、4～5岁、6～10岁、11～20岁、≥21岁.在11～20岁,≥21岁年龄段,女性测量值均小于男性(P<0.05).按血流频谱对年龄进行聚类分析,分为4类:≤30岁、31～50岁、51～80岁、≥81岁.心脏各瓣口血流速度性别间差异无统计学意义.按左心室收缩功能各项指标对年龄进行聚类分析,分为6类:<1岁、1～3岁、4～5岁、6～10岁、11～15岁、≥16岁.在11～15岁、≥16岁年龄段,每搏输出量及心输出量男性均高于女性(P<0.05).按左心室舒张功能各项指标对年龄进行聚类分析,分为5类:≤15岁、16～30岁、31～50岁、51～80岁、≥81岁.左心室舒张功能各项指标性别间差异无统计学意义.结论 中国人心脏发育分为6个阶段,21岁以后心脏结构固定.左心室收缩功能在16岁以后呈稳定状态.左心室舒张功能随年龄增长呈生理性减低.

Impact of age and gender on cardiac structure and function in normal Chinese population

Objective To identify the impact of age and gender on cardiac structure and left ventricular function in normal Chinese by echocardiography. Methods Cardiac structure, valve flow velocity and cardiac function were measured by echocardiography in 15 692 healthy volunteers. Subjects were grouped by age at 5 years interval in population older than 5 years. Children under 5 years were divided into 3 age groups(<1 years,1-3 years,4-5 years). Hierarchical cluster analyses were performed for ages, based on indexes of cardiac structure and function respectively. Results Six groups (< 1 years, 1-3 years,4-5 years, 6-10 years, 11-20 years, ≥21 years) were generated after the age hierarchical cluster analyses based on index of cardiac structure. Four groups (≤30 years, 31-50 years, 51-80 years,≥81 years) were generated based on spectral current flow. Six groups (< 1 years,1-3 years,4-5 years, 6-10 years, 11-15 years, ≥16 years) were generated baaed on left ventricular systolic function and five groups (≤15 years, 16-30 years, 31-50 years, 51-80 years, ≥81 years) were generated based on left ventricular diastolic function. Cardiac structure index were similar between male and female in age groups ≤ 10 years and significantly lower in females than males in age groups ≥ 11 years (P < 0.05). Valve flow velocity was similar between male and female in various age groups (P >0.05). Left ventricular systolic function was similar between male and female in age groups ≤10 years but was significantly higher in males than females in age groups ≥11 years(all P <0.05). Left ventricular diastolic function was similar between female and male in various age groups (P > 0.05) and equally decreased with aging in both female and male subjects. Conclusions The cardiac development in Chinese population can be divided in 6 phases and becomes stable in subjects older than 21 years, left ventricular systolic function becomes stable in subjects older than 16 years and the left ventricular diastolic function declines physiologically with aging.