title: Age-related changes in intraventricular kinetic energy: a physiological or pathological adaptation?
abstract: Aging has important deleterious effects on the cardiovascular system. We sought to compare intraventricular kinetic energy (KE) in healthy subjects of varying ages with subjects with ventricular dysfunction to understand if changes in energetic momentum may predispose individuals to heart failure. Four-dimensional flow MRI was acquired in 35 healthy subjects (age: 1-67 yr) and 10 patients with left ventricular (LV) dysfunction (age: 28-79 yr). Healthy subjects were divided into age quartiles (1st quartile: <16 yr, 2nd quartile: 17-32 yr, 3rd quartile: 33-48 yr, and 4th quartile: 49-64 yr). KE was measured in the LV throughout the cardiac cycle and indexed to ventricular volume. In healthy subjects, two large peaks corresponding to systole and early diastole occurred during the cardiac cycle. A third smaller peak was seen during late diastole in eight adults. Systolic KE (P = 0.182) and ejection fraction (P = 0.921) were preserved through all age groups. Older adults showed a lower early peak diastolic KE compared with children (P < 0.0001) and young adults (P = 0.025). Subjects with LV dysfunction had reduced ejection fraction (P < 0.001) and compared with older healthy adults exhibited a similar early peak diastolic KE (P = 0.142) but with the addition of an elevated KE in diastasis (P = 0.029). In healthy individuals, peak diastolic KE progressively decreases with age, whereas systolic peaks remain constant. Peak diastolic KE in the oldest subjects is comparable to those with LV dysfunction. Unique age-related changes in ventricular diastolic energetics might be physiological or herald subclinical pathology.
authors.affiliation: Department of Imaging Sciences, Kings College London, St Thomas' Hospital, London, United Kingdom;
authors.forename: James
authors.initials: J
authors.lastname: Wong
authors.affiliation: Department of Imaging Sciences, Kings College London, St Thomas' Hospital, London, United Kingdom; Inria and Paris-Saclay University, Palaiseau, France.
authors.forename: Radomir
authors.initials: R
authors.lastname: Chabiniok
authors.affiliation: Department of Imaging Sciences, Kings College London, St Thomas' Hospital, London, United Kingdom;
authors.forename: Adelaide
authors.initials: A
authors.lastname: deVecchi
authors.affiliation: Department of Imaging Sciences, Kings College London, St Thomas' Hospital, London, United Kingdom;
authors.forename: Nathalie
authors.initials: N
authors.lastname: Dedieu
authors.affiliation: Department of Imaging Sciences, Kings College London, St Thomas' Hospital, London, United Kingdom;
authors.forename: Eva
authors.initials: E
authors.lastname: Sammut
authors.affiliation: Department of Imaging Sciences, Kings College London, St Thomas' Hospital, London, United Kingdom;
authors.forename: Tobias
authors.initials: T
authors.lastname: Schaeffter
authors.affiliation: Department of Imaging Sciences, Kings College London, St Thomas' Hospital, London, United Kingdom; reza.razavi@kcl.ac.uk.
authors.forename: Reza
authors.initials: R
authors.lastname: Razavi
mesh_terms: D000222:Adaptation, Physiological / Q000502:physiology*; D000293:Adolescent; D000328:Adult; D000367:Age Factors; D000368:Aged; D000375:Aging / Q000502:physiology*; D001783:Blood Flow Velocity / Q000502:physiology*; D016022:Case-Control Studies; D002648:Child; D002675:Child, Preschool; D003971:Diastole; D005260:Female; D006801:Humans; D007223:Infant; D007700:Kinetics; D019028:Magnetic Resonance Imaging, Cine; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D013318:Stroke Volume / Q000502:physiology*; D013599:Systole; D018487:Ventricular Dysfunction, Left / Q000503:physiopathology*; D016277:Ventricular Function, Left / Q000502:physiology*; D055815:Young Adult
keywords: cardiac function; cardiovascular magnetic resonance; energy; four-dimensional phase-contrast magnetic resonance imaging; heart failure