Age-Related Vascular Stiffness and Left Ventricular Size After Myocardial Infarction

American Journal of Geriatric Cardiology Pub Date : 2007-07-02 DOI:10.1111/j.1076-7460.2007.05849.x

Glenn A. Hirsch MD, MHS, W. Patricia Ingkanisorn MD, Steven P. Schulman MD, Gary Gerstenblith MD, Christopher K. Dyke MD, Kenneth L. Rhoads MD, Richard Thompson PhD, Anthony H. Aletras PhD, Andrew E. Arai MD

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引用次数: 12

Abstract

Aortic stiffness increases with age and may contribute to adverse remodeling after myocardial infarction (MI). The authors examined whether vascular stiffness affects left ventricular (LV) size after MI using contrast-enhanced cardiac magnetic resonance imaging. Despite similar infarct sizes, patients aged 60 years or older (n=30) had a lower ejection fraction (42±15 vs 53±11%, P<.01) and greater end-systolic volume index (75±47 vs 44±18 mL/m², P<.01) than younger patients (n=19). As infarct size increased, LV end-systolic volumes (P<.0001) and ejection fraction (P<.0001) in the older participants were progressively greater. Participants with greater aortic stiffness had greater end-systolic volume indices (P<.0001) and lower ejection fraction (P<.0001) with increasing infarct size. Using multivariate analysis, MI size (P<.001) and aortic distensibility (P=.02) were significant predictors of end-systolic volume index. Older patients have increased LV size after MI compared with younger patients, possibly related to age-related decreases in aortic distensibility affecting LV remodeling.

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心肌梗死后与年龄相关的血管硬度和左心室大小

主动脉硬度随着年龄的增长而增加，并可能导致心肌梗死(MI)后的不良重构。作者使用增强心脏磁共振造影检查心肌梗死后血管硬度是否影响左室(LV)大小。尽管梗死面积相似，60岁及以上患者(n=30)的射血分数(42±15 vs 53±11%，P< 0.01)低于年轻患者(n=19)，收缩期末期容积指数(75±47 vs 44±18 mL/m2, P< 0.01)。随着梗死面积的增大，老年受试者左室收缩末容积(P< 0.0001)和射血分数(P< 0.0001)逐渐增大。随着梗死面积的增加，主动脉硬度越大的受试者收缩末期容积指数越大(P< 0.0001)，射血分数越低(P< 0.0001)。通过多因素分析，心肌梗死大小(P<.001)和主动脉扩张度(P=.02)是收缩末期容积指数的显著预测因子。与年轻患者相比，老年患者心肌梗死后左室大小增大，这可能与年龄相关的主动脉扩张性降低影响左室重塑有关。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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