title: Age-related vascular stiffness and left ventricular size after myocardial infarction.
abstract: Aortic stiffness increases with age and may contribute to adverse remodeling after myocardial infarction (MI). The authors examined whether vascular stiffness affects left ventricular (LV) size after MI using contrast-enhanced cardiac magnetic resonance imaging. Despite similar infarct sizes, patients aged 60 years or older (n=30) had a lower ejection fraction (42+/-15 vs 53+/-11%, P<.01) and greater end-systolic volume index (75+/-47 vs 44+/-18 mL/m(2), P<.01) than younger patients (n=19). As infarct size increased, LV end-systolic volumes (P<.0001) and ejection fraction (P<.0001) in the older participants were progressively greater. Participants with greater aortic stiffness had greater end-systolic volume indices (P<.0001) and lower ejection fraction (P<.0001) with increasing infarct size. Using multivariate analysis, MI size (P<.001) and aortic distensibility (P=.02) were significant predictors of end-systolic volume index. Older patients have increased LV size after MI compared with younger patients, possibly related to age-related decreases in aortic distensibility affecting LV remodeling.
authors.affiliation: Laboratory of Cardiac Energetics, National Heart, Lung, and Blood Institute, National Institutes of Health, Department of Health and Human Services, Bethesda, MD, USA. ghirsch@jhmi.edu
authors.forename: Glenn A
authors.initials: GA
authors.lastname: Hirsch
authors.forename: W Patricia
authors.initials: WP
authors.lastname: Ingkanisorn
authors.forename: Steven P
authors.initials: SP
authors.lastname: Schulman
authors.forename: Gary
authors.initials: G
authors.lastname: Gerstenblith
authors.forename: Christopher K
authors.initials: CK
authors.lastname: Dyke
authors.forename: Kenneth L
authors.initials: KL
authors.lastname: Rhoads
authors.forename: Richard
authors.initials: R
authors.lastname: Thompson
authors.forename: Anthony H
authors.initials: AH
authors.lastname: Aletras
authors.forename: Andrew E
authors.initials: AE
authors.lastname: Arai
mesh_terms: D000367:Age Factors; D000368:Aged; D001011:Aorta / Q000473:pathology; D002318:Cardiovascular Diseases / Q000209:etiology; D003430:Cross-Sectional Studies; D005260:Female; D006352:Heart Ventricles / Q000187:drug effects / Q000473:pathology*; D006801:Humans; D008279:Magnetic Resonance Imaging; D008297:Male; D008875:Middle Aged; D009203:Myocardial Infarction / Q000150:complications*; D012189:Retrospective Studies; D012307:Risk Factors; D013318:Stroke Volume; D018487:Ventricular Dysfunction, Left / Q000209:etiology*