A new index of "cardiac age" derived from echocardiography: influence of hypertension and comparison with pulse wave velocity.
Although pulse wave velocity is the primary indicator of arteriosclerosis and is widely used as an index of vascular age in anti-aging medicine, no index is available to quantify cardiac age. We proposed a "cardiac age" index and sought to clarify its clinical significance. The study subjects were 234 patients with atherosclerosis-related diseases. These patients were divided into 127 normotensive (mean age: 64+/-12 years) and 107 hypertensive (mean age: 65+/-11 years) patients. Echocardiography was performed, and brachial-ankle pulse wave velocity (baPWV) was measured using an automatic waveform analyzer. The index of cardiac age was determined as 1,000xVS(ot)/BSA/(VS-AO), where VSot (mm) was the ventricular septal thickness at the left ventricular outflow tract, BSA (m2) was the body surface area, and VS-AO (degree) was the angle between the basal ventricular septum and the ascending aorta. The index of cardiac aging correlated significantly with age in both the normotensive (r=0.63, p<0.001) and hypertensive (r=0.58, p<0.001) patients, and these correlations were closer than those between transmitral E/A (early to atrial velocity) ratio and age in normotensive (r=0.54, p<0.001) and hypertensive (r=0.44, p<0.001) patients. The slope between age (x-axis) and the index of cardiac age (y-axis) was greater in hypertensive (1.50) than normotensive (1.32) patients. Stepwise regression analysis showed that age (beta coefficient=0.35, p<0.001), the presence of hypertension (beta coefficient=0.26, p<0.001), the left ventricular mass index (beta coefficient=0.34, p<0.001), the left ventricular end-diastolic dimension (beta coefficient=-0.35, p<0.001), the dimension of the left atrium (beta coefficient=0.14, p=0.014), and the ratio of E to A (E/A) (beta coefficient=-0.12, p=0.046) were independently associated with the index of cardiac age. The index was also significantly correlated with baPWV (r=0.53, p<0.001). The proposed index of cardiac age can quantitatively assess cardiac morphological changes due to aging and/or hypertension and may be a useful marker of peripheral arterial stiffening.
Masugata
Hisashi
H
Department of Integrated Medicine, Kagawa University, Kagawa, Japan. masugata@med.kagawa-u.ac.jp
Senda
Shoichi
S
Goda
Fuminori
F
Hirao
Tomohiro
T
Yoshihara
Yumiko
Y
Yoshikawa
Kay
K
Himoto
Takashi
T
Miyashita
Hiroaki
H
Imai
Masanobu
M
Yukiiri
Kazushi
K
Kohno
Masakazu
M
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000375:Aging; D000842:Ankle / Q000098:blood supply; D001783:Blood Flow Velocity; D001916:Brachial Artery / Q000502:physiology; D004452:Echocardiography / Q000379:methods*; D005260:Female; D006801:Humans; D006973:Hypertension / Q000000981:diagnostic imaging* / Q000503:physiopathology*; D008297:Male; D008875:Middle Aged; D008955:Models, Cardiovascular