Mitral flow derived Doppler indices of left ventricular diastolic function in a general population; the Tromso study

Area of Science:

• Cardiology
• Medical Imaging
• Physiology

Background:

• Left ventricular diastolic dysfunction is a key factor in heart failure with preserved ejection fraction.
• Mitral inflow Doppler indices are commonly used to assess diastolic function and correlate with left atrial pressure.
• Existing diagnostic criteria may not adequately account for age and gender variations.

Purpose of the Study:

• Establish age-specific normal criteria for mitral inflow Doppler indices.
• Determine the influence of age and cardiovascular disease on these indices.
• Evaluate the need for revised diagnostic criteria for diastolic dysfunction.

Main Methods:

• Pulsed Doppler measurements of mitral inflow velocities and early inflow deceleration time were obtained from 3022 subjects (aged 25-85).
• Age- and gender-specific associations were analyzed in a healthy reference subsample (n=949).
• Statistical analysis explored the variance explained by age, gender, and cardiovascular disease.

Main Results:

• Peak early mitral inflow velocity and E/A ratio significantly declined with age.
• Early inflow deceleration time and peak atrial inflow velocity significantly increased with age.
• Cardiovascular disease explained only 7% of variance in deceleration time, but 41-48% of variance in E/A ratio.

Conclusions:

• Age and gender significantly impact mitral Doppler indices used for diastolic dysfunction assessment.
• Provided age- and gender-specific criteria for normality.
• Current Doppler criteria for diastolic dysfunction require revision to incorporate these findings.