Patients with Alzheimer disease have altered transmitral flow: echocardiographic analysis of the vortex formation time.
OBJECTIVE
There is considerable epidemiologic evidence that Alzheimer disease (AD) is linked to cardiovascular risk factors and associated with an increased risk of symptomatic left ventricular (LV) dysfunction. Formation of a vortex alongside a diastolic jet signifies an efficient blood transport mechanism. The vortex formation time (VFT) is an index of optimal conditions for vortex formation. We hypothesized that AD and its associated cardiovascular risk factors impair diastolic transmitral flow efficiency and, therefore, shift the VFT value out of its optimal range.


METHODS
Echocardiographic studies were performed on 45 participants in total: 22 patients with AD diagnosed according to the American Psychiatric Association's criteria and 23 age-matched individuals as a control group with cognitive function within normal limits.


RESULTS
The echocardiographic ratio of the early to atrial phases of the LV filling velocities was significantly lower in the AD group (mean +/- SD, 0.67 +/- 14) when compared with the control individuals (0.79 +/- 0.14; P = .003). The interventricular septum diastolic thickness, left ventricular posterior wall diastolic thickness, and right ventricular end-diastolic diameter were significantly higher in the AD group (P <or= 0.04). The mitral annular diameters in the control and AD groups were nearly identical (P = .725). The time-velocity integral of the E wave had a lower value in the AD group than in the control group (P = .05), whereas the VFT was significantly lower in the AD group (P = .018).


CONCLUSIONS
Our study suggests that patients with AD have impaired transmitral flow efficiency of diastolic filling, as measured by the VFT, compared with age-matched control individuals.
Belohlavek
Marek
M
Translational Ultrasound Research Laboratory, Division of Cardiovascular Diseases, Mayo Clinic, Scottsdale, Arizona, USA.
Jiamsripong
Panupong
P
Calleja
Anna M
AM
McMahon
Eileen M
EM
Maarouf
Chera L
CL
Kokjohn
Tyler A
TA
Chaffin
Teresa L
TL
Vedders
Linda J
LJ
Garami
Zsolt
Z
Beach
Thomas G
TG
Sabbagh
Marwan N
MN
Roher
Alex E
AE
D000368:Aged; D000544:Alzheimer Disease / Q000150:complications / Q000000981:diagnostic imaging / Q000503:physiopathology*; D001783:Blood Flow Velocity; D004452:Echocardiography / Q000379:methods; D005260:Female; D006801:Humans; D008297:Male; D008943:Mitral Valve / Q000503:physiopathology*; D013318:Stroke Volume; D018487:Ventricular Dysfunction, Left / Q000000981:diagnostic imaging / Q000209:etiology / Q000503:physiopathology*