Age-related alterations of Doppler left ventricular filling indexes in normal subjects are independent of left ventricular mass, heart rate, contractility and loading conditions

Abstract

The purpose of this study was to determine whether age-related alterations in Doppler diastolic filling indexes occur independent of cardiovascular disease and confounding physiologic variables. Ten old (62 to 73 years) and 10 young (21 to 32 years) healthy male volunteers were rigorously screened for cardiovascular disease and underwent comprehensive Doppler echocardiography, radionuclide ventriculography and invasive measurements of right heart and left atrial pressures. There were no differences between the two groups in the physiologic variables of left ventricular mass, volumes, ejection fraction, end-systolic wall stress, left atrial size, heart rate and right atrial, pulmonary artery, pulmonary capillary wedge and systemic arterial pressures. However, there were marked differences in Doppler left ventricular filling indexes. Compared with the young group, the old group had reduced peak early diastolic flow velocity (56 +/- 13 vs. 82 +/- 12 cm/s, p = 0.0002) and increased atrial diastolic flow velocity (59 +/- 14 vs. 43 +/- 10 cm/s, p = 0.009) and had a peak atrial/early flow velocity (A/E) ratio twice that of the young group (1.09 +/- 0.29 vs. 0.54 +/- 0.15, p less than 0.0001). Similar results were obtained for the time-velocity integrals of the peaks. Subjects in the old group also had a markedly reduced peak filling rate (274 +/- 62 vs. 448 +/- 152 ml/s, p = 0.004). In univariate and multivariate regression analyses, peak early and atrial flow velocities were not related to any of the physiologic variables measured once age was accounted for, although peak filling rate, a volumetric measure flow, was related to body surface area as well as age.(ABSTRACT TRUNCATED AT 250 WORDS)

Uric Acid, Left Ventricular Mass Index, and Risk of Cardiovascular Disease in Essential Hypertension

“…It is well described that early diastolic relaxation decreases with increasing age. 24 In the present study, we also found that DcT had a significant positive relationship with age (male: rϭ0. 36 …”

Mitral Ratio of Peak Early to Late Diastolic Filling Velocity as a Predictor of Mortality in Middle-Aged and Elderly Adults

“…1,2 The age-related alterations in Doppler diastolic filling indexes are independent of LV mass, heart rate, contractility, and loading conditions. 1 Of these measures, the ratio of peak early to late diastolic filling velocity (E/A ratio) is the simplest and most commonly used index to assess diastolic filling. Individuals with low E/A are considered to have impaired early diastolic relaxation; those with high E/A have a restrictive filling pattern.…”

Frequência de disfunção diastólica do ventrículo esquerdo pelo doppler mitral em idosos sadios

“…One can observe significant modifications in the transmitral Doppler, tissue Doppler imaging of mitral annulus and pulmonary venous Doppler profiles at the older age ranges, similar to those found in diseases that course with impaired left ventricular (LV) relaxation filling [1][2][3][4][5][6][7] . However, not all elderly individuals exhibit altered mitral and pulmonary venous Doppler profiles 8,9 .…”

“…The relative thickness of the LV walls was determined by dividing the sum of the diastolic thickness of the interventricular septum (IVS) and the posterior wall (PW) by the LV diastolic diameter (LVDD). The ventricular mass was obtained through the formula: LV mass (g) = 1.04 [(LVDD + IVS + PW) 3 -(LVDD) 3 -13.6)]; and corrected for the body surface area 13 . Doppler examination of the mitral inflow was performed from the apical 4-chamber view with the sample volume placed between the mitral leaflet tips.…”