title: Longitudinal myocardial dysfunction in healthy older subjects as a manifestation of cardiac ageing.
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 (S(m)), early diastolic (E(m)) and late diastolic (A(m)) 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.
authors.affiliation: The University of Hull, Academic Department of Cardiology, Castle Hill Hospital, Kingston-upon-Hull HU16 5JQ, UK. n.p.nikitin@hull.ac.uk
authors.forename: Nikolay P
authors.initials: NP
authors.lastname: Nikitin
authors.forename: Klaus K A
authors.initials: KK
authors.lastname: Witte
authors.forename: Lee
authors.initials: L
authors.lastname: Ingle
authors.forename: Andrew L
authors.initials: AL
authors.lastname: Clark
authors.forename: T Alan
authors.initials: TA
authors.lastname: Farnsworth
authors.forename: John G F
authors.initials: JG
authors.lastname: Cleland
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000375:Aging / Q000502:physiology*; D003971:Diastole; D015150:Echocardiography, Doppler; D006801:Humans; D008875:Middle Aged; D009200:Myocardial Contraction / Q000502:physiology*; D016277:Ventricular Function, Left / Q000502:physiology*