Abnormalities of Doppler measures of diastolic function in the healthy elderly are not related to alterations of left
Anand Prasad1, Kazunobu Okazaki, Armin Arbab-Zadeh
1Institute for Exercise and Environmental Medicine, Presbyterian Hospital and the University of Texas Southwestern Medical Center at Dallas, TX 75231, USA.
Circulation
|March 23, 2005
Summary
Aging hearts show decreased transmitral filling (E/A ratio) and prolonged relaxation time. However, pulmonary capillary wedge pressure remains unchanged, refuting the theory of lower early diastolic left atrial pressure in older adults.
Area of Science:
- Cardiology
- Gerontology
- Physiology
Background:
- Normal aging alters Doppler indexes of diastolic function, potentially due to impaired myocardial relaxation or altered left atrial compliance.
- A proposed theory suggests that reduced early left atrial pressure in aged hearts rises rapidly, maintaining normal mean pressure.
- Investigating age-related changes in left atrial pressure is crucial for understanding diastolic dysfunction.
Purpose of the Study:
- To directly explore the theory of altered left atrial compliance in aging by analyzing pulmonary capillary wedge pressure waveforms.
- To compare left atrial pressure dynamics during varying loading conditions between young and elderly healthy subjects.
- To determine if a lower early diastolic left atrial pressure contributes to age-related changes in Doppler diastolic function indexes.
Main Methods:
- Recruited 12 healthy elderly (mean age 69.8 years) and 12 young (mean age 35 years) sedentary subjects, screened for comorbidities.
- Performed transthoracic echocardiography to assess Doppler variables (E/A ratio, isovolumetric relaxation time).
- Conducted pulmonary artery catheterization to measure pulmonary capillary wedge pressure waveform under 5 loading conditions (baseline, negative pressure, saline infusion).
Main Results:
- Echocardiography revealed a decreased E/A ratio (P<0.001) and prolonged isovolumetric relaxation time (P<0.001) in elderly subjects.
- Pulmonary capillary wedge pressure showed no significant age-related differences at any point in the cardiac cycle (P=0.290).
- Left atrial pressure in seniors was not lower than in young subjects at any measured point or filling volume.
Conclusions:
- The observed age-related decrease in the E/A ratio is not attributable to lower early diastolic left atrial pressure.
- The findings challenge the hypothesis that altered left atrial compliance, specifically reduced early diastolic pressure, explains age-related diastolic function changes.
- Further research is needed to elucidate the precise mechanisms behind age-associated alterations in diastolic function.
Keywords:
Non-programmatic
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