title: A new index of "cardiac age" derived from echocardiography: influence of hypertension and comparison with pulse wave velocity.
abstract: 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.
authors.affiliation: Department of Integrated Medicine, Kagawa University, Kagawa, Japan. masugata@med.kagawa-u.ac.jp
authors.forename: Hisashi
authors.initials: H
authors.lastname: Masugata
authors.forename: Shoichi
authors.initials: S
authors.lastname: Senda
authors.forename: Fuminori
authors.initials: F
authors.lastname: Goda
authors.forename: Tomohiro
authors.initials: T
authors.lastname: Hirao
authors.forename: Yumiko
authors.initials: Y
authors.lastname: Yoshihara
authors.forename: Kay
authors.initials: K
authors.lastname: Yoshikawa
authors.forename: Takashi
authors.initials: T
authors.lastname: Himoto
authors.forename: Hiroaki
authors.initials: H
authors.lastname: Miyashita
authors.forename: Masanobu
authors.initials: M
authors.lastname: Imai
authors.forename: Kazushi
authors.initials: K
authors.lastname: Yukiiri
authors.forename: Masakazu
authors.initials: M
authors.lastname: Kohno
mesh_terms: 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