title: Left ventricular diastolic function and exercise capacity in community-dwelling adults ≥65 years of age without heart failure.
abstract: Left ventricular diastolic dysfunction (LVDD) has been reported to have strong correlation with exercise capacity. However, this relationship has not been studied extensively in community-dwelling older adults. Data on pulse and tissue Doppler echocardiographic estimates of resting early (E) and atrial (A) transmitral peak inflow and early (Em) mitral annular velocities, and six-minute walk test were obtained from 89 community-dwelling older adults (mean age, 74; range, 65-93 years; 54% women), without a history of heart failure. Overall, 47% had cardiovascular morbidity and 60% had normal diastolic function (E/A 0.75-1.5 and E:Em <10). Among the 36 individuals with LVDD, 83%, 14% and 3% had grade I (E/A <0.75, regardless of E/E(m)), II (E/A 0.75-1.5 and E/E(m) ≥10) and III (E/A>1.5 and E/E(m) ≥10) LVDD, respectively. Those with LVDD were older (77 versus 73 years; p = 0.001) and had a trend for higher prevalence of cardiovascular morbidity (58% versus 40%; p = 0.083). LVDD negatively correlated with six-minute walk distance (1013 versus 1128 feet; R = -0.25; p = 0.017). This association remained significant despite adjustment for cardiovascular morbidity (R = -0.35; p = 0.048), but lost significance when adjusted for age (R = -0.32; p = 0.105), age and cardiovascular morbidity (R = -0.38; p = 0.161), and additional adjustment for sex, race, body mass index, and systolic blood pressure (R = -0.44; p = 0.365). In conclusion, most community-dwelling older adults without heart failure had normal left ventricular diastolic function or grade-I LVDD. Although LVDD was associated with decreased performance on a six-minute walk test, that association was no longer evident after adjustment for age, body mass index and cardiovascular morbidity.
authors.affiliation: VA Medical Center, Birmingham, Alabama, USA.
authors.forename: Gilbert J
authors.initials: GJ
authors.lastname: Perry
authors.forename: Mustafa I
authors.initials: MI
authors.lastname: Ahmed
authors.forename: Ravi V
authors.initials: RV
authors.lastname: Desai
authors.forename: Marjan
authors.initials: M
authors.lastname: Mujib
authors.forename: Michael
authors.initials: M
authors.lastname: Zile
authors.forename: Xuemei
authors.initials: X
authors.lastname: Sui
authors.forename: Inmaculada B
authors.initials: IB
authors.lastname: Aban
authors.forename: Yan
authors.initials: Y
authors.lastname: Zhang
authors.forename: Jose
authors.initials: J
authors.lastname: Tallaj
authors.forename: Richard M
authors.initials: RM
authors.lastname: Allman
authors.forename: Wilbert S
authors.initials: WS
authors.lastname: Aronow
authors.forename: Jerome L
authors.initials: JL
authors.lastname: Fleg
authors.forename: Ali
authors.initials: A
authors.lastname: Ahmed
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D003971:Diastole / Q000502:physiology*; D015150:Echocardiography, Doppler; D004562:Electrocardiography; D005080:Exercise Test; D005260:Female; D006801:Humans; D008297:Male; D010807:Physical Endurance / Q000502:physiology*; D012307:Risk Factors; D018487:Ventricular Dysfunction, Left / Q000000981:diagnostic imaging / Q000503:physiopathology*; D016138:Walking / Q000502:physiology