'Abnormal' diastolic Doppler patterns in patients over age 65 with severe left ventricular systolic dysfunction

Area of Science:

• Cardiology
• Echocardiography
• Geriatric Medicine

Background:

• Elderly individuals normally show increased atrial contribution to left ventricular filling.
• Myocardial stiffness in the elderly can lead to increased A wave velocity.

Purpose of the Study:

• To investigate alterations in Doppler diastolic filling patterns of the left ventricle in elderly patients (over 65) with impaired systolic function compared to those with normal function.

Main Methods:

• Age and sex-matched comparison of 27 patients with left ventricular systolic dysfunction and 19 with normal systolic function.
• Exclusion of patients with significant valvular disease.
• Calculation of maximal early inflow velocity, maximal atrial inflow velocity, heart rate, acceleration time, and deceleration time.

Main Results:

• Patients with systolic dysfunction exhibited pseudonormalization of the early/atrial flow velocity ratio (P=0.003) and diminished A wave velocity (P=0.02).
• Deceleration time was significantly shorter in the dysfunction group (P<0.001), while E wave velocity and acceleration time were similar between groups.

Conclusions:

• Observed Doppler pattern differences may indicate increased left atrial and/or left ventricular diastolic pressures, or decreased atrial systolic function.
• These findings are critical for accurate interpretation of left ventricular filling indices in elderly patients using Doppler echocardiography.