LEFT-VENTRICULAR DIASTOLIC FUNCTION IN A POPULATION-SAMPLE OF ELDERLYMEN

Background and Methods: Echocardiography with Doppler has been widely used to assess left ventricular (LV) diastolic function. Interpretatio n of the diastolic indices that are derived, however, is confounded by the effects of physiological aging on, the LV diastolic function. In this study, the usefulness of different Doppler-derived indices of LV diastolic function was assessed in elderly subjects by using data from a health screening survey of 584 men aged 70 years. Results: The inde x of early versus late transmitral blood flow the EIA ratio, was found to be reduced in the apparently healthy subgroup (n = 195) of the pop ulation. (0.96 +/- 0.25) compared with previous data from middle-aged subjects. However, EIA ratios similar to those in the apparently healt hy subjects were found in subjects with coronary heart disease (CHD), hypertension, and diabetes mellitus. Only subjects with systolic dysfu nction (ejection fraction < 40%) showed a significantly decreased E/A ratio (0.79 +/- 0.21, P < 0.05) compared with the apparently healthy s ubjects. Isovolumic relaxation time (IVRT) was, however significantly prolonged in subjects with CHD or hypertension compared with the appar ently healthy subjects (139 +/- 32 127 +/- 25, and 118 +/- 21 millisec onds, respectively; P < 0.01), whereas the E wave deceleration times ( DT) were alike in both apparently healthy and unhealthy subjects. The diastolic and systolic components of the pulmonary venous blood flow w ere alike in apparently healthy and unhealthy subjects. Left atrial si ze was increased in, all patients with disease, possibly indicating in creased preload. Conclusion: In this population sample of elderly men, the commonly used EIA ratio did not distinguish between, apparently h ealthy subjects and those with cardiovascular diseases such as CHD or hypertension, which are known to be associated with LV diastolic dysfu nction in the middle-aged population. IVRT appeared to be the most sen sitive of the Doppler-derived indices of LV diastolic function used in the present study, but for this variable, the differences between app arently healthy subjects and unhealthy subjects were small. Thus, the age-associated changes in LV compliance appear to override the impact of these disorders on indices of LV diastolic function in elderly popu lations.