The impact of age and gender on right ventricular diastolic function among healthy adults.
BACKGROUND
Doppler echocardiography is ideally suited for assessment of diastolic function, being widely available, non-invasive, and less expensive than other techniques. However, data regarding age- and gender-matched reference values of right ventricular diastolic function are limited. This study aims to explore the physiologic variations of right ventricle (RV) diastolic function in a large cohort of healthy adults, and to investigate clinical and echocardiographic correlates.


METHODS
From June 2007 to February 2014, 1168 healthy Caucasian subjects [mean age 45.1±15.6 years, range 16-92; 555 (47.5%) men] underwent comprehensive transthoracic echocardiography (TTE) following current guidelines. The following RV main diastolic measurements were measured: peak early inflow velocity (E), annular both early (e') and atrial (a') velocities, E/e' ratio.


RESULTS
RV E/e' constantly increases with age in females, but do not change substantially in males. RV E/A constantly decreases with age in both genders. Stepwise multiple linear regression analysis underlined a close significant association of RV diastolic function with both right and left heart morphologic measurements (right atrial area, RV diameters, left atrial volume) and functional indexes (TAPSE, RV tissue Doppler peak systolic velocity, left ventricular E/Ee'), as well as with indexes of increased pulmonary resistance.


CONCLUSIONS
Our data highlight the potential usefulness of different normal reference values according to the age and gender to correctly evaluate RV diastolic function. Differences in terms of demographic and anthropometric parameters could be useful to avoid potential misclassification of RV diastolic function when based on dichotomously suggested normal cut-off values.
Department of Cardiology, Second University of Naples, Monaldi Hospital-AORN Ospedali dei Colli, Naples, Italy. Electronic address: antonellodandrea@libero.it.
Antonello
A
D'Andrea
Department of Cardiology and Emergency Medicine of San Antonio Hospital, San Daniele del Friuli, Udin, Italy.
Olga
O
Vriz
Department of Cardiology, Second University of Naples, Monaldi Hospital-AORN Ospedali dei Colli, Naples, Italy.
Andreina
A
Carbone
Department of Cardiology and Cardiac Surgery, University Hospital San Giovanni di Dio, Salern, Italy.
Francesco
F
Ferrara
Department of Cardiology, Second University of Naples, Monaldi Hospital-AORN Ospedali dei Colli, Naples, Italy.
Marco
M
Di Maio
Department of Cardiology, Second University of Naples, Monaldi Hospital-AORN Ospedali dei Colli, Naples, Italy.
Rosangela
R
Cocchia
Department of Cardiology, Second University of Naples, Monaldi Hospital-AORN Ospedali dei Colli, Naples, Italy.
Gianluigi
G
Tagliamonte
Department of Cardiology and Cardiac Surgery, University Hospital San Giovanni di Dio, Salern, Italy.
Edwige
E
Acri
Department of Cardiology and Emergency Medicine of San Antonio Hospital, San Daniele del Friuli, Udin, Italy.
Caterina
C
Driussi
Department of Cardiology, Second University of Naples, Monaldi Hospital-AORN Ospedali dei Colli, Naples, Italy.
Enrica
E
Pezzullo
Department of Cardiology and Cardiac Surgery, University Hospital San Giovanni di Dio, Salern, Italy.
Rodolfo
R
Citro
Department of Internal Medicine, Federico II University, Naples, Italy.
Antonio
A
Cittadini
Department of Cardiology, Second University of Naples, Monaldi Hospital-AORN Ospedali dei Colli, Naples, Italy.
Raffaele
R
Calabrò
Department of Cardiology, Second University of Naples, Monaldi Hospital-AORN Ospedali dei Colli, Naples, Italy.
Maria
M
Giovanna Russo
Department of Cardiology and Cardiac Surgery, University Hospital San Giovanni di Dio, Salern, Italy.
Eduardo
E
Bossone
D000293:Adolescent; D000328:Adult; D000367:Age Factors; D000368:Aged; D000369:Aged, 80 and over; D015331:Cohort Studies; D003971:Diastole / Q000502:physiology*; D004452:Echocardiography; D005260:Female; D006325:Heart Atria / Q000000981:diagnostic imaging; D006352:Heart Ventricles / Q000000981:diagnostic imaging*; D006801:Humans; D008297:Male; D008875:Middle Aged; D012016:Reference Values; D012737:Sex Factors; D013599:Systole; D016278:Ventricular Function, Right / Q000502:physiology*; D055815:Young Adult
Diastole; E/e′; Echocardiography; Reference ranges; Right ventricle