中老年人左心室舒张功能减退及其相关危险因素——广州生物库心血管疾病亚队列研究

Objective: To study left ventricular diastolic function and its risk factors in relatively healthy older people in Guangzhou. Methods: A cross-sectional investigation was performed in a random sample, from the Guangzhou Biobank Cohort Study, of 390 individuals aged 50 years or above and without apparent diseases including stroke ,myocardial infarction, COPD and cancers. Personal history, blood pressure, fasting glucose and lipids were assessed. Color Doppler ultrasound was used to measure indicators of left ventricular diastolic function, including peak E velocity and peak A velocity of mitral diastolic flow (E) and (A), E/A ratio, the deceleration time of peak E (DT), and isovolumic relaxation time(IVRT). Results: ① With increasing age,peak A significantly increased and E/A level significantly decreased (all P<0.05). ② After adjusting age and sex, A and IVRT increased, while E/A decreased with waist circumference. Moreover, A increased with triglyceride and fasting plasma glucose(all P<0.05). ③ After adjusting age and sex, A was positively associated with systolic and diastolic blood pressure (all P<0.05), while E/A was negatively associated with systolic and diastolic blood pressure in tertiles in 310 individuals without antihypertensive medication(all P<0.05). ④ There was a trend of increase in A (P<0.05) and decrease in E/A (P<0.05) from optimal to normal blood pressure to hypertension. Conclusions: Higher blood pressure was an independent risk factor for left ventricular diastolic dysfunction. Even within normal blood pressure level, left ventricular diastolic function may deteriorate with increased blood pressure.