Evaluation of echocardiographic parameters in Japanese patients aged over 90 years at a single institution

The number of patients aged over 90 years undergoing transthoracic echocardiography (TTE) has increased. Normal echocardiographic measurement values in healthy Japanese aged 20-79 years have been reported by Daimon et al., and in those aged 10-89 years by Okura et al. To date, no researchers have published normal values in healthy Japanese aged  over 90 years. To understand the echocardiographic characteristics and establish the normal range, we evaluated patients aged  over 90 years who had preserved left ventricular (LV) ejection fraction without cardiovascular disease.

Enrolled in the study were consecutive patients aged  over 90 years who were examined by TTE at the Ultrasound Imaging Center at Nagasaki University Hospital, Japan, between September 2009 and May 2016. We selected patients with LV ejection fraction > 55%, and without cardiac, renal, or aortic disease.

Among a total of 956 patients, 73 patients (19 males, 54 females) were admitted. Compared with females, males had significantly higher values of aortic diameter at the sinus of Valsalva and LV diastolic diameter and systolic diameter (P < 0.01), significantly lower E wave velocities (P < 0.01) and left ventricle mass (P < 0.01), and lower values of relative wall thickness (P < 0.01). Compared with subjects in their 70s and 80s in the studies by Daimon and Okura, the E and A wave velocities were higher.

We established the normal range of TTE parameters in elderly patients who had LV ejection fraction > 55% without cardiac, renal, or aortic disease. Sex differences were present as well as a tendency towards age-related changes in LV geometry and diastolic function. Most of the patients aged  over 90 years had LV hypertrophy and potential diastolic dysfunction.