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Age-related changes in cardiovascular performance in mitral regurgitation: analysis of 61 patients
Insights
Older patients with chronic mitral regurgitation (MR) exhibit higher left ventricular (LV) end-diastolic pressure, indicating increased myocardial stiffness. This age-related change occurs regardless of coronary artery disease (CAD) presence.
Area of Science:
- Cardiology
- Geriatric Medicine
- Cardiovascular Physiology
Background:
- Chronic mitral regurgitation (MR) affects cardiovascular performance.
- Age is a significant factor influencing cardiovascular health.
- The interplay between MR, age, and coronary artery disease (CAD) requires further investigation.
Purpose of the Study:
- To investigate the relationship between age and cardiovascular parameters in patients with moderate to severe chronic MR.
- To assess the influence of co-existing coronary artery disease (CAD) on these age-related cardiovascular changes.
Main Methods:
- Cross-sectional study of 61 patients with moderate or severe chronic MR.
- Patients were stratified by age (less than 60 years vs. 60 years or older) and presence of CAD.
- Key cardiovascular parameters including pulmonary artery pressure, systemic arterial pressure, left ventricular (LV) end-diastolic pressure, and pulmonary artery wedge pressure were measured.
Main Results:
- Patients aged 60 years or older demonstrated significantly higher pulmonary artery pressure, systolic arterial pressure, LV end-diastolic pressure, and pulmonary artery wedge pressure compared to younger patients.
- In patients without CAD, older individuals still exhibited higher LV end-diastolic pressure and systemic arterial pressure.
- LV end-diastolic pressure showed a consistent age-related increase, irrespective of CAD status.
Conclusions:
- Older age is associated with elevated LV end-diastolic pressure in patients with chronic MR.
- Increased myocardial stiffness likely contributes to the higher LV end-diastolic pressure observed in older MR patients.
- These findings highlight age-dependent cardiovascular alterations in chronic MR, potentially exacerbated by myocardial stiffness.
Abstract:
This study examines the cardiovascular performance in relation to age in 61 patients with moderate or severe chronic mitral regurgitation (MR). Coronary artery disease (CAD) (50% or more diameter narrowing of one or more major coronary arteries) was present in 20 patients (33%). Patients less than 60 years (n = 33) had lower pulmonary artery pressure, systolic arterial pressure, left ventricular (LV) end-diastolic pressure, and pulmonary artery wedge pressure than the patients greater than or equal to 60 years (n = 28) (p less than 0.05). In the 41 patients without associated CAD, the LV end-diastolic pressure and systemic arterial pressure were higher in patients greater than or equal to 60 years (n = 14) than patients less than 60 years (n = 27) (p less than 0.05). The LV end-diastolic pressure showed an age-related increase in the presence or absence of CAD. Thus, older patients with MR have higher LV end-diastolic pressure, probably because of an increase in myocardial stiffness.