Author + information
- Received February 19, 1991
- Revision received April 3, 1991
- Accepted May 21, 1991
- Published online November 1, 1991.
- Dalane W. Kitzman, MD∗,1,
- Khalid H. Sheikh, MD, FACC,
- Polly A. Beere, MD, PhD,
- Judy L. Philips, RCVT and
- Michael B. Higginbotham, MB
- ↵∗Address for reprints: Dalana W. Kitzman, MD, Box 31219, Division of Cardiology, Duke University Medical Center, Durham, NC 27710.
The purpose of this study was to determine whether age-related alterations in Doppler diastolic filling indexes occur independent of cardiovascular disease and confounding physiologic variables. Ten old (62 to 73 years) and 10 young (21 to 32 years) healthy male volunteers were rigorously screened for cardiovascular disease and underwent comprehensive Doppler echocardiography, radionuclide ventriculography and invasive measurements of right heart and left atrial pressures. There were no differences between the two groups in the physiologic variables of left ventricular mass, volumes, ejection fraction, end-systolic wall stress, left atrial size, heart rate and right atrial, pulmonary artery, pulmonary capillary wedge and systemic arterial pressures. However, there were marked differences in Doppler left ventricular filling indexes. Compared with the young group, the old group had reduced peak early diastolic flow velocity (56 ± 13 vs. 82 ±12 cm/s, p = 0.0002) and increased atrial diastolic flow velocity (59 ± 14 vs. 43 ± 10 cm/s, p = 0.009) and had a peak atrial/early flow velocity (A/E) ratio twice that of the young group (1.09 ± 0.29 vs. 0.54 ± 0.15, p < 0.0001). Similar results were obtained for the time-velocity integrals of the peaks. Subjects in the old group also had a markedly reduced peak filling rate (274 ± 62 vs. 448 ±152 ml/s, p = 0.004). In univariate and multivariate regression analyses, peak early and atrial flow velocities were not related to any of the physiologic variables measured once age was accounted for, although peak filling rate, a volumetric measure of flow, was related to body surface area as well as age.
These results suggest that an altered Doppler diastolic mitral flow profile may be a primary biologic effect of aging, intrinsic to the aged human heart, and may not be explicable by other physiologic and pathologic changes that frequently accompany the aging process.
↵1 Dr. Kitzman is the recipient of Grant-in-Aid 1988-89-A-24 from the Chapel Hill, North Carolina Affiliate of the American Heart Association, a research grant from the American Federation for Aging Research, New York, New York and a GRTC research pilot grant from the National Institute on Aging, Bethesda, Maryland.
☆ This study was supported in part by Grant HL-1760 from the National Heart, Lung, and Blood Institute. Bethesda, Maryland, by Core Grant AG-00371-17 from the Duke University Aging Registry, Grant AG-0943-01 from the Duke University Gerontology Research and Training Center (GRTC) and the Geriatric Research, Education, and Clinical Center at the Veterans Affairs Medical Center, Durham, North Carolina.
☆☆ This study was presented in part at the 39th Annual Scientific Session of the American College of Cardiology, New Orleans, Louisiana, March 1990 and the Annual Meeting of the American Geriatrics Society and the American Federation for Aging Research, Atlanta, Georgia, May 1990.
- Received February 19, 1991.
- Revision received April 3, 1991.
- Accepted May 21, 1991.