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Age and Ageing Advance Access originally published online on February 25, 2005
Age and Ageing 2005 34(4):343-349; doi:10.1093/ageing/afi043
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© The Author 2005. Published by Oxford University Press on behalf of the British Geriatrics Society. All rights reserved. For Permissions, please email: journals.permissions@oupjournals.org

Research Paper

Longitudinal myocardial dysfunction in healthy older subjects as a manifestation of cardiac ageing

Nikolay P. Nikitin1, Klaus K. A. Witte1, Lee Ingle1, Andrew L. Clark1, T. Alan Farnsworth2 and John G. F. Cleland1

1 The University of Hull, Academic Department of Cardiology, Castle Hill Hospital, Kingston-upon-Hull HU16 5JQ, UK
2 Castle Hill Hospital, Department of Medicine for the Elderly, Kingston-upon-Hull HU16 5JQ, UK

Address correspondence to: N. P. Nikitin. Email: n.p.nikitin{at}hull.ac.uk

Abstract

Background: abnormalities of longitudinal left ventricular (LV) contraction and relaxation may be early markers of cardiac disease. This study was designed to assess the relationship between long-axis LV function and age in healthy subjects.

Methods: 118 healthy individuals aged 57 ±19 years (range 20–90 years) with no evidence of cardiovascular disease under-went echocardiography with Doppler examination of transmitral flow. To assess longitudinal LV function, systolic (Sm), early diastolic (Em) and late diastolic (Am) mitral annular velocities were measured using colour-coded tissue Doppler imaging.

Results: the left atrium was enlarged (P<0.001) in subjects ≥60 years of age compared to those <60 years, but there were no differences in LV volumetric indices and ejection fraction. Peak E velocity was lower (P<0.001) and peak A velocity of transmitral flow was higher in older subjects (P<0.001) with a higher E/A ratio (P<0.001) and longer isovolumic relaxation time (P= 0.001) indicative of impaired ventricular relaxation. S m and E m mitral annular velocities decreased (P<0.001) and A m velocity increased (P=0.002) in the older group. E m velocity and E m /A m ratio showed a strong negative correlation with age (r= –0.80, P<0.001 and r=–0.78, P<0.001, respectively).

Conclusions: global LV systolic function is preserved but the velocity of long-axis systolic shortening is depressed in older individuals, indicating selective impairment of the longitudinal component of systolic contraction. The decline in the velocity of early diastolic long-axis LV lengthening and the changes in the pattern of transmitral flow suggest impaired ventricular relaxation. These measures of cardiac function may be a useful index of normal cardiac ageing.

Keywords: ageing, ventricular function, left, systole, diastole, echocardiography, Doppler, elderly, longitudinal myocardial dysfunction, cardiac ageing

Received March 7, 2004; Revision received December 6, 2004. accepted in revised form December 6, 2004.


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