The Impact of Age and Sex on Left Ventricular Function Based on Transthoracic Echocardiograms

This study aimed to reveal the age- and gender-related differences in left ventricular function among patients with normal cardiac structure.

A retrospective analysis was performed on 10,853 individuals with normal cardiac structures undergoing transthoracic echocardiography (2017-2020). We performed distribution analysis using kernel density estimation with Gaussian kernels and created smooth trajectories based on generalized additive models. Moreover, correlation analysis and multivariable regression were applied to evaluate the impact of age and gender on ventricular function.

A weak but statistically significant correlation was found between age and ejection fraction (B-coefficient = -0.077, p < 0.001). Females presented with a higher early diastolic mitral inflow velocity (E)/ early diastolic mitral annular tissue velocity (e') ratio than males across all age decades (p < 0.001). However, age demonstrated stronger associations with functional parameters in individuals below 51.4 years (both genders, p < 0.001). Multivariable regression analysis indicated that age and the male gender were independent predictors of reduced septal and lateral e' velocities (both p < 0.001), with males showing lower values (septal B-coefficient = -0.290; lateral B-coefficient = -0.463).

This study provided the distribution of left ventricular systolic/diastolic function across age decades in males and females and highlighted the clinical importance of monitoring ventricular function even for patients with normal cardiac structure.