Echocardiographic evaluation of left ventricular end-systolic elastance in the elderly.
BACKGROUND
The aging heart is characterized by structural changes, which are implicated in the development of left ventricular diastolic dysfunction. However, important changes in systolic function may also occur. Left ventricular end-systolic elastance (E(es)) is a major determinant of cardiac systolic function and ventricular-arterial interaction.


OBJECTIVE
To evaluate left-ventricular E(es) in elderly subjects compared with adult control subjects.


METHODS
We studied dilated (DA, n=14) and hypertensive (HA, n=21) cardiomyopathy patients, and both adult control (A, n=25; age 55.6+/-6.6 years) and elderly (E, n=25; age 76.3+/-7.1 years) subjects without clinical-instrumental evidence of cardiovascular disease. M-mode, two-dimensional, and pulsed Doppler echocardiogram were performed. Doppler-derived indices of diastolic function were assessed and E(es) was calculated by a modified single-beat method.


RESULTS
E(es) was reduced in dilated cardiomyopathy (1.32+/-0.10 mm Hg/ml) and increased in hypertensive cardiomyopathy (3.12+/-0.33 mm Hg/ml) patients compared to age-matched control subjects (1.96+/-0.26 mm Hg/ml; p<0.01 and p<0.05, respectively). More importantly, E(es) was higher in the elderly (2.52+/-0.70 mm Hg/ml) than in the adult control group (p<0.05) and was linearly correlated with age (r2=0.639; p<0.0001).


CONCLUSIONS
Age-related increase in E(es), together with diastolic dysfunction, may lead to aging heart decompensation.
de Santis
Domenico
D
Dipartimento di Medicina Clinica, Scienze Cardiovascolari ed Immunologiche, Università degli Studi di Napoli Federico II, Via S. Pansini, 5, 80131 Naples, Italy.
Abete
Pasquale
P
Testa
Gianluca
G
Cacciatore
Francesco
F
Galizia
Gianluigi
G
Leosco
Dario
D
Viati
Luisa
L
Del Villano
Vincenzo
V
Della Morte
David
D
Mazzella
Francesca
F
Ferrara
Nicola
N
Rengo
Franco
F
D000368:Aged; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D013599:Systole / Q000502:physiology*; D018608:Ultrasonography, Doppler; D018617:Ultrasonography, Doppler, Pulsed; D018487:Ventricular Dysfunction, Left / Q000000981:diagnostic imaging* / Q000503:physiopathology*