Is the aging heart similar to the diabetic heart? Evaluation of LV function of the aging heart with Tissue Doppler Imaging.
OBJECTIVE
Left ventricular (LV) function in the healthy aging heart is modified by biochemical changes with advancing age. We employed for the first time Tissue Doppler Imaging (TDI), to identify which phase of the cardiac cycle is involved.


METHODS
TDI was performed in 175 aging subjects, free of cardiovascular and/or respiratory disease (group II), and in 182 healthy adults enrolled as the control group (group I), to calculate the Myocardial Performance Index (MPI). The index derives from the values of Isovolumetric Contraction Time (ICT), Isovolumetric Relaxation Time (IRT) and Left Ventricular Ejection Time (LVET) measured in ms, according to the formula: (ICT+IRT)/LVET.


RESULTS
An increase in MPI in group II was shown, with significant lengthening of IRT in comparison with the same value obtained in the control group (group I), ICT and LVET were unchanged.


CONCLUSIONS
The rise in IRT in the aging healthy heart is dependent on diastolic LV dysfunction consequent upon the formation of Advanced Glycosilation End-product (AGE) crosslinks with connectival proteins of interstitial myocardial tissue. Agerelated increase in oxidative stress also modifies some interstitial compounds, favoring hardening of ventricular walls. These changes are similar to those happening in the diabetic heart, and TDI seems to be able to define non-invasively which phase of the cardiac cycle is impaired.
Cacciapuoti
Fulvio
F
Echocardiography, Department of Geriatrics and Metabolic Disease, II University of Naples, Naples, Italy.
Marfella
Raffaele
R
Paolisso
Giuseppe
G
Cacciapuoti
Federico
F
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000375:Aging / Q000502:physiology*; D001786:Blood Glucose / Q000378:metabolism; D001794:Blood Pressure / Q000502:physiology; D015992:Body Mass Index; D002784:Cholesterol / Q000097:blood; D003920:Diabetes Mellitus / Q000503:physiopathology*; D018619:Echocardiography, Doppler, Pulsed; D005260:Female; D006321:Heart / Q000502:physiology* / Q000503:physiopathology*; D006339:Heart Rate / Q000502:physiology; D006801:Humans; D008297:Male; D008875:Middle Aged; D013318:Stroke Volume / Q000502:physiology; D014280:Triglycerides / Q000097:blood; D018487:Ventricular Dysfunction, Left / Q000503:physiopathology; D016277:Ventricular Function, Left / Q000502:physiology*
D001786:Blood Glucose; D014280:Triglycerides; D002784:Cholesterol