Changes in left ventricular size, geometry, pump function and left heart pressures during healthy aging.

Area of Science:

• Cardiovascular Physiology
• Geriatric Cardiology
• Cardiac Imaging

Background:

• Age-related changes in cardiac structure and function are well-documented.
• Existing studies link echocardiography and cardiac MRI findings to aging in healthy adults.
• Invasive pressure measurements also show age-related associations.

Purpose of the Study:

• To synthesize current understanding of age-related alterations in left ventricular (LV) structure and function.
• To examine the relationship between aging and invasively measured left heart pressures.
• To clarify the divergence between ejection fraction (LVEF) and overall LV pump function in older adults.

Main Methods:

• Cross-sectional and longitudinal imaging studies (echocardiography, cardiac MRI).
• Analysis of invasively measured left heart chamber pressures.
• Comparison of cardiac parameters between younger and older adult subjects.

Main Results:

• Older adults exhibit decreased LV end-diastolic volume (LVEDV), end-systolic volume (LVESV), stroke volume (SV), and cardiac output (CO).
• Increased relative wall thickness (RWT) and LV mass/LVEDV ratio (LVMVR) are observed with aging.
• LV end-diastolic pressure (LVEDP) increases with age, while mean left atrial (LA) pressure remains unchanged.

Conclusions:

• Aging leads to reduced LV capacity and impaired preload reserve, indicated by lower LVEDV and higher LVEDP.
• An increasing divergence between LVEF and actual LV pump function occurs with age.
• These findings highlight significant age-associated changes in cardiac hemodynamics and function.