DELAYED LEFT-VENTRICULAR EARLY FILLING WITH AGING - LOSS OF RESTORINGFORCES

Left ventricular (LV) early filling is altered by the aging process. A delay of LV relaxation is considered the main factor responsible for this alteration. It has been demonstrated that the restoring forces ar e involved in normal LV filling but their possible modification with a ging is incompletely understood. In this study, we analyze the phase d ifferences between LV wall motion in early diastole and mitral inflow velocity as indirect evidence of the restoring forces in normal subjec ts and their possible modification with aging. We studied 45 subjects divided according to age into three groups of 15 subjects (group 1 = 1 2.6 +/- 3.5 years, group 2 = 39 +/- 6 years, group 3 = 74 +/- 7 years) . By means of digitized M-mode continui ous wave and pulsed wave Doppl er echocardiography, with simultaneous recording of electrocardiograms and phonocardiograms, we measured early LV diastolic events from seco nd aortic sound (A2) to mitral opening, onset of flow, peak of early f illing, and peak of the LV dimension changes' first derivative, and we studied the relationship between LV dimension and flow. A progressive decrease of phase difference between LV wall motion and transmitral f low (group 1 = 51 msec, group 2 = 15 msec, group 3 = -2 msec; p < 0.00 1 for group 3 vs. group 1) was found, together with a progressive incr ease of the mean values of the measured intervals. Our data strongly s uggest the existence of a progressive loss of the ventricular restorin g forces in the pathophysiology of altered LV early filling with aging .