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Age-related vascular stiffness and left ventricular size after myocardial infarction

Glenn A Hirsch1, W Patricia Ingkanisorn, Steven P Schulman

  • 1Laboratory of Cardiac Energetics, National Heart, Lung, and Blood Institute, National Institutes of Health, Department of Health and Human Services, Bethesda, MD, USA. ghirsch@jhmi.edu

The American Journal of Geriatric Cardiology
|July 10, 2007
PubMed

Insights

Older adults experience larger left ventricular (LV) size after myocardial infarction (MI), linked to reduced aortic distensibility. This age-related vascular stiffness impacts LV remodeling post-MI.

Area of Science:

  • Cardiovascular Medicine
  • Gerontology
  • Biomedical Engineering

Background:

  • Aortic stiffness, a marker of vascular aging, is associated with cardiovascular disease.
  • Myocardial infarction (MI) can lead to adverse left ventricular (LV) remodeling.
  • Age-related vascular changes may influence LV remodeling after MI.

Purpose of the Study:

  • To investigate the impact of vascular stiffness on LV size and remodeling following MI.
  • To compare LV remodeling in older versus younger patients after MI.
  • To identify predictors of LV remodeling after MI, considering age and aortic stiffness.

Main Methods:

  • Contrast-enhanced cardiac magnetic resonance imaging (CE-CMR) was used to assess LV size and function.
  • Patients were stratified by age (≥60 years vs. <60 years) and infarct size.
  • Aortic stiffness was quantified using aortic distensibility measurements.

Main Results:

  • Older patients (≥60 years) exhibited significantly lower ejection fraction and greater LV end-systolic volume index compared to younger patients, despite similar infarct sizes.
  • LV end-systolic volumes increased and ejection fraction decreased progressively with increasing infarct size in older participants.
  • Higher aortic stiffness correlated with greater LV end-systolic volume index and lower ejection fraction, particularly with larger infarct sizes.
  • MI size and aortic distensibility were significant independent predictors of LV end-systolic volume index.

Conclusions:

  • Older patients demonstrate increased LV size after MI, suggesting impaired remodeling.
  • Age-related decreases in aortic distensibility may contribute to adverse LV remodeling post-MI.
  • Vascular stiffness is a critical factor influencing LV remodeling outcomes after myocardial infarction.

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