| HOME | HELP | FEEDBACK | SUBSCRIPTIONS | ARCHIVE | SEARCH | TABLE OF CONTENTS |
|
|
|
|||||||
|
|||||||||
1Division of Cardiology, Johns Hopkins University School of Medicine; and 2Laboratory of Cardiovascular Science, Gerontology Research Center, National Institute on Aging, Baltimore, Maryland 21224
Submitted 28 December 2002 ; accepted in final form 23 September 2003
Changes in diastolic indexes during normal aging, including reduced early filling velocity (E), lengthened E deceleration time (DT), augmented late filling (A), and prolonged isovolumic relaxation time (IVRT), have been attributed to slower left ventricular (LV) pressure (LVP) decay. Indeed, this constellation of findings is often referred to as the "abnormal relaxation" pattern. However, LV filling is determined by the atrioventricular pressure gradient, which depends on both LVP decline and left atrial (LA) pressure (LAP). To assess the relative influence of LVP decline and LAP, we studied 122 normal subjects aged 21–92 yr by Doppler echocardiography and MRI. LVP decline was assessed by color M-mode (Vp) and the LV untwisting rate. Early diastolic LAP was evaluated using pulmonary vein flow systolic fraction, pulmonary vein flow diastolic DT, color M-mode (E/Vp), and tissue Doppler (E/Em). Linear regression showed the expected reduction of E, increase in A, and prolongation of IVRT and DT with advancing age. There was no relation of age to parameters reflecting the rate of LVP decline. However, older age was associated with reduced E/Vp (P = 0.008) and increased pulmonary vein systolic fraction (P < 0.001), pulmonary vein DT (P = 0.0026), and E/Em (P < 0.0001), all suggesting reduced early LAP. Therefore, reduced early filling in older adults may be more closely related to a reduced early diastolic LAP than to slower LVP decline. This effect also explains the prolonged IVRT. We postulate that changes in LA active or passive properties may contribute to development of the abnormal relaxation pattern during the aging process.
left ventricular deformation; torsion; untwist; noninvasive imaging; left atrial pressure
This article has been cited by other articles:
|
|
 |
|
  J. Wang, D. S. Khoury, Y. Yue, G. Torre-Amione, and S. F. Nagueh Left Ventricular Untwisting Rate by Speckle Tracking Echocardiography Circulation, November 27, 2007; 116(22): 2580 - 2586. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 V. Melenovsky, B. A. Borlaug, B. Rosen, I. Hay, L. Ferruci, C. H. Morell, E. G. Lakatta, S. S. Najjar, and D. A. Kass Cardiovascular Features of Heart Failure With Preserved Ejection Fraction Versus Nonfailing Hypertensive Left Ventricular Hypertrophy in the Urban Baltimore Community: The Role of Atrial Remodeling/Dysfunction J. Am. Coll. Cardiol., January 16, 2007; 49(2): 198 - 207. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
E. Foster and K. E. Lease New Untwist on Diastole: What Goes Around Comes Back Circulation, May 30, 2006; 113(21): 2477 - 2479. [Full Text] [PDF]
|
|
|
|
|
|
Y. Notomi, G. Srinath, T. Shiota, M. G. Martin-Miklovic, L. Beachler, K. Howell, S. J. Oryszak, D. G. Deserranno, A. D. Freed, N. L. Greenberg, et al. Maturational and Adaptive Modulation of Left Ventricular Torsional Biomechanics: Doppler Tissue Imaging Observation From Infancy to Adulthood Circulation, May 30, 2006; 113(21): 2534 - 2541. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 G. de Simone, D. W. Kitzman, M. Chinali, A. Oberman, P. N. Hopkins, D. C. Rao, D. K. Arnett, and R. B. Devereux Left ventricular concentric geometry is associated with impaired relaxation in hypertension: the HyperGEN study Eur. Heart J., May 2, 2005; 26(10): 1039 - 1045. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
A. E. Weyman The year in echocardiography J. Am. Coll. Cardiol., February 1, 2005; 45(3): 448 - 455. [Full Text] [PDF]
|
|
| HOME | HELP | FEEDBACK | SUBSCRIPTIONS | ARCHIVE | SEARCH | TABLE OF CONTENTS |
| Visit Other APS Journals Online |
