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Increased left ventricular mass is not associated with impaired left ventricular diastolic filling in normal
J A Deague1, C M Wilson, L E Grigg
1Department of Physiology, University of Melbourne, The Royal Melbourne Hospital, Parkville, Victoria, Australia.
Insights
Left ventricular mass index (LVMI) does not explain diastolic filling differences. Age-related decline in diastolic filling reflects myocardial tissue quality changes, not size.
Area of Science:
- Cardiology
- Cardiovascular Physiology
- Echocardiography
Background:
- Hypertensive left ventricular hypertrophy is linked to diastolic dysfunction.
- The physiological link between left ventricular size and diastolic function requires clarification.
- This study investigates diastolic filling and left ventricular mass in a healthy population.
Purpose of the Study:
- To evaluate the relationship between diastolic filling measures and left ventricular mass.
- To clarify the physiological connection between left ventricular size and diastolic function.
Main Methods:
- Utilized M-mode and Doppler echocardiography in 159 healthy volunteers.
- Compared left ventricular mass index (LVMI) and wall thickness with five diastolic filling parameters.
- Assessed parameters including mitral inflow velocity ratios, deceleration time, isovolumetric relaxation time, and pulmonary venous/mitral inflow wave characteristics.
Main Results:
- Men exhibited significantly higher LVMI than women, but no gender differences in diastolic filling were found.
- Increased age, blood pressure, and heart rate correlated with diminished diastolic filling.
- No diastolic filling measure correlated with LVMI or wall thickness in univariate or multiple regression analyses.
Conclusions:
- Left ventricular mass index (LVMI) does not account for physiological variations in diastolic filling.
- The age-associated decline in diastolic filling is attributed to alterations in myocardial tissue quality, not quantity.
Background:
Hypertensive left ventricular (LV) hypertrophy has been associated with diastolic dysfunction. However, the underlying physiological relationship between LV size and diastolic function remains to be clarified. The aim of this study was to evaluate the relationship between several measures of diastolic filling and LV mass in a population sample.
Methods:
We used M-mode and Doppler echocardiography to compare left ventricular mass index (LVMI) and wall thickness with five measures of ventricular diastolic filling (ratio of the peak early mitral inflow velocity to the peak atrial mitral inflow velocity, deceleration time of early mitral inflow, isovolumetric relaxation time, ratio of the peak pulmonary venous systolic to diastolic flow and difference between the durations of the pulmonary venous and mitral inflow atrial waves) in 159 healthy volunteers.
Results:
LVMI was significantly (P< 0.0001) greater in men (81.3 g/m2, interquartile range: 67-94) than women (59.7 g/m2, interquartile range: 49-74), but no gender differences were observed in diastolic filling. Higher age, blood pressure and heart rate showed significant correlation with diminished diastolic filling. However, no measure of diastolic filling correlated with LVMI or wall thickness in either univariate or multiple regression analyses that adjusted for relevant covariates.
Conclusions:
LVMI does not explain physiological differences in diastolic filling. The significant decline in diastolic filling with age reflects changes in the quality rather than the quantity of myocardial tissue.