Longitudinal myocardial dysfunction in healthy older subjects as a manifestation of cardiac ageing

• Published in: Age and ageing Vol. 34; no. 4; pp. 343 - 349
• Main Authors: Nikitin, Nikolay P., Witte, Klaus K. A., Ingle, Lee, Clark, Andrew L., Farnsworth, T. Alan, Cleland, John G. F.
• Format: Journal Article
• Language: English
• Published: England Oxford University Press 01-07-2005; Oxford Publishing Limited (England)
• Subjects: Adult; Aged; Aged, 80 and over; ageing; Aging; Aging (Biology); Aging - physiology; cardiac ageing; Cardiomyopathy; Cardiovascular disease; Case studies; Diastole; Doppler; Doppler echocardiography; echocardiography; Echocardiography, Doppler; Elderly; Health; Health aspects; Heart diseases; Humans; left; longitudinal myocardial dysfunction; Middle Aged; Myocardial Contraction - physiology; Myocardial diseases; Older people; systole; ventricular function; Ventricular Function, Left - physiology
• DOI: 10.1093/ageing/afi043
• EISSN: 1468-2834
• ISSN: 0002-0729

Background: abnormalities of longitudinal left ventricular (LV) contraction and relaxation may be early markers of cardiac disease. This study was designed to assess the relationship between long-axis LV function and age in healthy subjects. Methods: 118 healthy individuals aged 57 ±19 years (range 20–90 years) with no evidence of cardiovascular disease under-went echocardiography with Doppler examination of transmitral flow. To assess longitudinal LV function, systolic (Sm), early diastolic (Em) and late diastolic (Am) mitral annular velocities were measured using colour-coded tissue Doppler imaging. Results: the left atrium was enlarged (P<0.001) in subjects ≥60 years of age compared to those <60 years, but there were no differences in LV volumetric indices and ejection fraction. Peak E velocity was lower (P<0.001) and peak A velocity of transmitral flow was higher in older subjects (P<0.001) with a higher E/A ratio (P<0.001) and longer isovolumic relaxation time (P= 0.001) indicative of impaired ventricular relaxation. S m and E m mitral annular velocities decreased (P<0.001) and A m velocity increased (P=0.002) in the older group. E m velocity and E m /A m ratio showed a strong negative correlation with age (r= −0.80, P<0.001 and r=−0.78, P<0.001, respectively). Conclusions: global LV systolic function is preserved but the velocity of long-axis systolic shortening is depressed in older individuals, indicating selective impairment of the longitudinal component of systolic contraction. The decline in the velocity of early diastolic long-axis LV lengthening and the changes in the pattern of transmitral flow suggest impaired ventricular relaxation. These measures of cardiac function may be a useful index of normal cardiac ageing.