Affiliation:
1. From the Division of Cardiology, The New York Hospital–Cornell Medical Center, New York (G. de S., M.J.R., R.B.D.); Department of Clinical and Experimental Medicine, Federico II University Hospital, Naples, Italy (G. de S., G.M., R.G.); and Children’s Hospital Medical Center, Division of Cardiology, Department of Pediatrics, University of Cincinnati (Ohio) (S.R.D., T.R.K.).
Abstract
Abstract
We evaluated the effect of body growth and aging on the ratio of echocardiographic (Teichholz) stroke volume to pulse pressure (SV/PP ratio) in 373 normal-weight, normotensive children to adolescents (1 day to 17 years old; 166 girls, 87 nonwhite) and 393 normal adults (17 to 85 years old; 164 women, 112 nonwhite). Stroke volume increased with age in children (
r
=.64,
P
<.0001) and was stable in adults; pulse pressure decreased slightly with age in children (
r
=−.10,
P
=.06) and increased in adults (
r
=.29,
P
<.0001). As a consequence, SV/PP ratio increased with age in children (
r
=.51,
P
<.0001) and decreased in adults (
r
=−.18,
P
=.0004). To control for changes in body size that influence the size of the arterial tree, we used ANCOVA to adjust SV/PP for body size. Body size–adjusted SV/PP ratio was no longer related to age in children, whereas the negative relation with aging in adults remained statistically significant (
r
=−.19,
P
<.0002). Heart rate was negatively related to SV/PP ratio in both children and adolescents and adults, but this relation did not influence the relation with age. In multivariate analysis, high SV/PP ratio was predicted by greater height (
P
<.002) and weight (
P
<.04) and nonwhite race (
P
<.001) in children and adolescents and by younger age (
P
<.0001), greater weight (
P
<.0001), and low heart rate (
P
<.001) in adults. Sex did not enter the regression models. Thus, (1) SV/PP ratio is a measure of increasing capacity of the arterial tree during growth, whereas it depends on arterial compliance during adulthood through old age; (2) arterial compliance decreases progressively with aging; (3) the apparent difference between males and females might be due to their different body sizes.
Publisher
Ovid Technologies (Wolters Kluwer Health)
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