Influence of Age and Sex on Left Ventricular Anatomy and Function in Normals

Grandi, Anna Maria; Venco, Achille; Barzizzá, F; Scalise, Filippo; Pantaleo, Paolo; Finardi, G

doi:10.1159/000175770

Cited by 43 publications

(27 citation statements)

References 17 publications

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“…Our observation of increased diastolic long-axis velocities in young women in nearly all segments and of reduced velocities in women of age group 3 compared with men corresponds well with previous reports describing improved diastolic function in young women 28 and reduced diastolic function compared with men with increased age. Decreased diastolic compliance 29 and a steeper age-related increase in systolic and diastolic vascular and ventricular stiffness in women 30 have been suggested as possible causes of the higher prevalence of diastolic heart failure.…”

Section: Diastolic Velocitiessupporting

confidence: 92%

Magnetic Resonance Tissue Phase Mapping of Myocardial Motion

Föll

Jung

Schilli

et al. 2010

Circ: Cardiovascular Imaging

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Background-An exact understanding of normal age-and gender-matched regional myocardial performance is an essential perquisite for the diagnosis of heart disease. Magnetic resonance phase-contrast imaging (tissue phase mapping) enabling the analysis of segmental, 3-directional myocardial velocities with high temporal resolution (13.8 ms) was used to assess left ventricular motion. Methods and Results-Radial, long-axis, and rotational myocardial velocities were acquired in 58 healthy volunteers (3 age groups, 29 women) in left ventricular basal, midventricular, and apical short-axis locations. For increased age, reduced (PϽ0.003) and prolonged long-axis and radial velocities (PϽ0.05) during diastole and reduced long-axis velocities (PϽ0.001) and apical rotation (PϽ0.005) during systole were found for both genders. Women demonstrated a reduced systolic twist (Pϭ0.009), apical rotation (Pϭ0.01), and systolic radial velocities (PϽ0.02) compared with men. Segmental analysis of long-axis motion with aging revealed differences in regional reduction of systolic (lateral 52% versus 30%) and diastolic (lateral 57% versus 41%) velocities in women compared with men. In basal segments, young women demonstrated higher long-axis velocities (ϩ11% during diastole) than men, whereas this difference was reversed in older subjects (same segments, Ϫ20%). In addition, increased age resulted in a prolonged time to peak diastolic apical rotation (PϽ0.04) in women compared with men. Conclusions-Age and gender strongly influence regional myocardial motion. Tissue phase mapping provides a comprehensive quantitative analysis of all myocardial velocities with high temporal and spatial resolution. The knowledge of the detected ageand gender-related differences in myocardial motion is fundamental for further investigations of cardiac disease. Clinical Trial Registration-http://www.zks.uni-freiburg.de/uklreg/php/suchergebnis_all.php. Identifier: UKF001739(Circ Cardiovasc Imaging. 2010;3:54-64.)Key Words: magnetic resonance imaging Ⅲ myocardial contraction Ⅲ aging Ⅲ gender V olumetric analysis of the left ventricle based on MRI has been established as a reference standard for the determination of left ventricular (LV) performance. 1 However, early changes in LV motion and regional pathologies may be overlooked by these global parameters because they do not reflect diastolic function or segmental contractility, which are not uniform within the healthy LV. 2 Therefore, a complete segmental analysis of velocities is preferable to detect subtle changes in LV motion. 3 Quantitative noninvasive assessment of regional myocardial performance still remains challenging. 4 Myocardial velocities and derived parameters mainly based on tissue Doppler imaging were suggested as markers for LV contractility 5 and diastolic function. 4 However, because tissue Doppler velocity analyses do not allow assessing all myocardial velocity components, ie, radial, long-axis, and rotational motion for the different LV regions, MRI applications have been developed as alterna...

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Section: Diastolic Velocitiessupporting

confidence: 92%

Magnetic Resonance Tissue Phase Mapping of Myocardial Motion

Föll

Jung

Schilli

et al. 2010

Circ: Cardiovascular Imaging

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“…Similar echocardiographic di mensions to those in another healthy control group [11] and similar E/A ratios to those in controls in the Fra mingham Heart Study [ 17] were found in our healthy con trols. E/A ratios ( fig.…”

Section: Healthy Individualssupporting

confidence: 89%

Age and Gender Differences in Left Ventricular Function among Patients with Stable Angina and a Matched Control Group

Eriksson

Björkander²,

Held³

et al. 1996

Cardiology

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To assess left ventricular systolic and diastolic function, M-mode (n = 675) and transmitral Doppler echocardiography (n = 358) were performed in patients with stable angina pectoris and compared with 50 matched healthy controls. Left ventricular fractional shortening (FS) was significantly lower in male than in female patients (32 ± 7 vs. 35 ± 7%, p < 0.001). A history of heart failure was as frequent in men (6%) as in women (6%), but left ventricular systolic dysfunction was more frequent in men than in women (25 vs. 12%, p < 0.005). The ratio of early/late diastolic peak flow velocity (E/A ratio) was significantly lower, indicating diastolic dysfunction, in female patients with clinical heart failure than in those without (0.79 ± 0.25 vs. 1.02 ± 0.3, p < 0.05). No such difference was found in male patients. Inverse relationships were found between age and E/A ratio in both controls (r = -0.45, p < 0.001) and angina patients (r = -0.44, p < 0.001). Thus, despite similar frequency of clinical heart failure, left ventricular systolic dysfunction was more common in men than in women with stable angina.

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“…Increased myocyte width is believed to increase ventricular wall thickness (19). Thus the difference in cell width between the sexes reported in our study may explain why left ventricular wall thickness increases with age in males but not in females (20,59). Although we found that cell area increased with age in myocytes from males and females, cell capacitance did not increase significantly with age in either group.…”

Section: Discussioncontrasting

confidence: 61%

Age-associated changes in excitation-contraction coupling are more prominent in ventricular myocytes from male rats than in myocytes from female rats

Howlett

2010

American Journal of Physiology-Heart and Circulatory Physiology

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We evaluated effects of age on components of excitation-contraction (EC) coupling in ventricular myocytes from male and female rats to examine sex differences in mechanisms responsible for age-related contractile dysfunction. Myocytes were isolated from anesthetized young adult (approximately 3 mo) and aged (approximately 24 mo) Fischer 344 rats. Ca(2+) concentrations and contractions were measured simultaneously (37 degrees C, 2 Hz). Fractional shortening declined with age in males (6.7 +/- 0.6% to 2.4 +/- 0.4%; P < 0.05), as did peak Ca(2+) transients (47.7 +/- 4.6 to 28.1 +/- 2.1 nM; P < 0.05) and Ca(2+) current densities (-7.7 +/- 0.7 to -6.2 +/- 0.5 pA/pF; P < 0.05). Although sarcoplasmic reticulum (SR) Ca(2+) content was similar regardless of age in males, EC coupling gain declined significantly with age to 55.8 +/- 7.8% of values in younger males. In contrast with results in males, contraction and Ca(2+) transient amplitudes were unaffected by age in females. Ca(2+) current density declined with age in females (-7.5 +/- 0.5 to -5.1 +/- 0.7 pA/pF; P < 0.05), but SR Ca(2+) content actually increased dramatically (49.0 +/- 7.5 to 147.3 +/- 28.5 nM; P < 0.05). Even so, EC coupling gain was not affected by age in female myocytes. Age also promoted hypertrophy of male myocytes more than female myocytes. Age and sex differences in EC coupling were largely maintained when conditioning pulse frequency was increased to 4 Hz. Contractions, Ca(2+) transients, and EC coupling gain were also smaller in young females than in young males. Thus age-dependent changes are more prominent in myocytes from males than females. Increased SR Ca(2+) content may compensate for reduced Ca(2+) current to preserve contractile function in aged females, which may limit the detrimental effects of age on cardiac contractile function.

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Influence of Age and Sex on Left Ventricular Anatomy and Function in Normals

Cited by 43 publications

References 17 publications

Magnetic Resonance Tissue Phase Mapping of Myocardial Motion

Magnetic Resonance Tissue Phase Mapping of Myocardial Motion

Age and Gender Differences in Left Ventricular Function among Patients with Stable Angina and a Matched Control Group

Age-associated changes in excitation-contraction coupling are more prominent in ventricular myocytes from male rats than in myocytes from female rats

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