Age-specific non-invasive transcutaneous Doppler ultrasound derived haemodynamic reference ranges in elderly Chinese adults

Abstract

BackgroundWhilst there is a presumption in medicine that ageing adversely affects cardiovascular function, it is unknown if resting haemodynamics are compromised in the elderly, and if so, to what degree. This study was intended to answer several questions; whether age-related changes in haemodynamics occur; whether there was a difference between the haemodynamics of ageing subjects with and without mild chronic disease; whether there was a difference in haemodynamics as measured from either the aortic or the pulmonary valve; and to establish reference ranges for this population.MethodsChinese adults aged over 60 years were divided into three age bands of 61–70, 71–80 and over 80 years. The haemodynamic parameters were measured using a non-invasive Doppler ultrasound-based instrument, the Ultrasonic Cardiac Output Monitor (USCOM).ResultsOne hundred and sixty-five subjects (48.5% males) were recruited. 78 (47.3%) had no known disease whilst 87 (52.7%) had mild chronic illness. A total of 21 individual haemodynamic parameters were measured or calculated for each subject. There were no significant differences in stroke volume (SV), cardiac output (CO), systemic vascular resistance (SVR) or in body surface area (BSA)-indexed parameters, SV index (SVI), cardiac index (CI) and SVR index (SVRI) across age groups, or in other indexed haemodynamic parameters. No significant differences in indexed haemodynamics were found between those subjects with and those without mild chronic disease. Small, statistically significant, but clinically insignificant, differences (< 5%) were found between the aortic and pulmonary valve measurements for SV, SVI and heart rate.ConclusionsAgeing does not have any significant effect on resting haemodynamics in the elderly population studied. Mild chronic disease does not adversely affect resting haemodynamics in this population.General SignificanceReference ranges were established for 21 haemodynamic parameters, as measured by USCOM, for an elderly Chinese population but not for non-Chinese populations.

The normal ranges of cardiovascular parameters measured using the ultrasonic cardiac output monitor

“…; Chan et al. ). However, there are no published ranges for adults, nor have ranges been derived according to subject weight, and no unifying overview of changes in hemodynamics from the first year of life to the elderly.…”

“…; Chan et al. ), in order to present normal ranges for all ages. To establish and compare normal ranges of USCOM‐derived hemodynamic variables according to weight and age.…”

Reference intervals and percentile curve for left ventricular outflow tract (LVOT), velocity time integral (VTI), and LVOT‐VTI‐derived hemodynamic parameters in healthy children and adolescents: Analysis of echocardiographic methods association and agreement

“…and (c) being a useful tool to follow up or monitor SV changes 1, 9,11 in different populations. 12,13 On the other hand, the limitations of A recent work showed that LVOT-VTI outperforms ejection fraction and Doppler-derived CO, as predictor of outcomes in a select advanced heart failure cohort. 55 Moreover, a recent study in children and adolescents with dilated cardiomyopathy indicated that LVOT-VTI could be a useful (alternative) LV performance index.…”

“…Changes in CO and left ventricle (LV) stroke volume (SV) could be quantified through PWD determinations using the velocity time integral (VTI) and the LV outflow tract (LVOT) diameter. LVOT‐VTI provides adequate information to follow changes in SV, and it has been proposed to be included in the Rapid Ultrasound in Shock protocol …”

“…1Changes in CO and left ventricle (LV) stroke volume (SV) could be quantified through PWD determinations using the velocity time integral (VTI) and the LV outflow tract (LVOT) diameter. LVOT-VTI provides adequate information to follow changes in SV, 1,9,[11][12][13] and it has been proposed to be included in the Rapid Ultrasound in Shock protocol. 9Despite the proven clinical usefulness of ultrasonic-derived CO indexes, there is lack of data regarding LVOT-VTI reference intervals (RIs), obtained from population-based studies in healthy people.…”