Effect of age and sex on echocardiographic left ventricular diastolic function parameters in patients with preserved ejection fraction and normal valvular function

Carvalho, Jean-Christophe; Farand, Paul; Hoa, Doan; Brochu, Marie-Claude; Bonenfant, Francis; Lepage, Serge

doi:10.5603/cj.2013.0137

Cited by 21 publications

(14 citation statements)

References 14 publications

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“…Consistent with previous observations [34, 35], in the present study postmenopausal women had a 30% lower E/A and a 33% higher E/e’ compared to premenopausal women, indicative of reduced LV diastolic function. The present study extends previous work by providing evidence for oxidative stress as one potential mechanism underlying these observed differences.…”

Section: Discussionsupporting

confidence: 93%

Acute ascorbic acid infusion increases left ventricular diastolic function in postmenopausal women

et al. 2016

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Objectives We tested the hypothesis that oxidative stress contributes to reductions in left ventricular diastolic function in estrogen-deficient postmenopausal women, related in part to reduced nitric oxide (NO) bioavailability. Study design LV diastolic function – recorded using transthoracic echocardiography and determined as the peak early (E) to late (A) mitral inflow velocity ratio and the E to peak early (e’) mitral annular velocity ratio – and brachial artery flow mediated dilation (FMD), a biomarker of NO bioavailability, were measured during acute systemic infusions of saline (control) and ascorbic acid (experimental model to decrease oxidative stress) in healthy premenopausal women (N=14, 18-40 years) and postmenopausal women (N=23, 45-75 years). Results The E/A ratio was lower (1.16[1.06−1.33] vs 1.65[1.5−2.3]; median[interquartile range]) and the E/e’ ratio was elevated (8.8[7.6−9.9] vs. 6.6[5.5−7.3]) in postmenopausal compared with premenopausal women, indicating reduced LV diastolic function. E/A and E/e’ were correlated with FMD (r=0.54 and r=−0.59, respectively, both P<0.01). Ascorbic acid infusion improved both FMD (5.4±2.0% to 7.8±2.6%) and E/e’ (to 8.1[7.2−9.7], P=0.01) in postmenopausal women but not in premenopausal women. Ascorbic acid did not change E/A in either group. Conclusion The current study provides evidence that oxidative stress contributes to reduced LV diastolic function in estrogen-deficient postmenopausal women, possibly by reducing the availability of NO.

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Section: Discussionsupporting

confidence: 93%

Acute ascorbic acid infusion increases left ventricular diastolic function in postmenopausal women

et al. 2016

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“…One of the most important findings of this study is that the Septal E/e´ ratio was only predictive in male patients for an elevated LVEDP, whereas female patients lacked any significant correlation. This is in accordance with higher baseline E/ e´ ratios in female patients than in male patients [21][22][23]. A potential explanation for the latter finding is that the E/e´ ratio increases in female patients with increasing age disproportionately compared in male patients [12,23].…”

Section: Gender and Age Difference In Diastolic Functionsupporting

confidence: 79%

“…In addition to this, the E/e´ ratio was noticeably higher in the highest three age decades [20]. Finally, a relation was shown between E/e´ ratio and gender [21][22][23]. A study, published in 2013, showed that baseline E/e´ ratios in men were lower in men than in women [23].…”

Section: Gender and Age Difference In Diastolic Functionmentioning

confidence: 95%

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Validation of Established Standard Values for the Correlation of E/e’ Ratio and Left Ventricular Diastolic Pressure in a Study of 190 Patients with Dyspnea– What are the Main Factors for the Observed Discrepancies?

2015

Angiol

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Aim: In the past, Mitral E/e' ratio has been recommended for detecting elevated left ventricular filling pressures. However, more recently, gender specific differences in E/e´ ratios have been demonstrated. The aim of this prospective study was to validate the established standard values for the correlation of E/e´ ratio and left ventricular end diastolic pressure LVEDP in 190 consecutive patients with dyspnea in terms of age and gender differences. Methods and results: 190 patients had sufficient echogenicity to allow complete assessment of the Doppler and tissue Doppler parameters. Overall, there was only a weak significant correlation between E/e´ ratio and LVEDP pre laevo cardiography (R=0.24, P=0.006). In patients with ejection fraction (EF) > 50% there was no significant correlation. Female patients had higher baseline E/e' ratios than male patients. An E/e' ratio > 15 for predicting an elevated LVEDP was only significant in male but not in female patients. E/e´ ratio increases progressively with age and is remarkable higher in women than in men. Irrespective of gender, a stratification of E/e' ratio < 8, 8-15 and > 15 did not allow prediction of LVEDP. Conclusions: Only male patients showed a significant correlation (R = 0.29, P = 0.012) between their E/e' and LVEDP with respect to difference in gender. Excessively high E/e´ ratios measured in women were less pathognomonic for diastolic dysfunction than in men.

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“…Left ventricular (LV) filling and ejection patterns are critical determinants of the stroke volume in individuals with preserved systolic function. Aging is known to affect diastolic function by reducing myocardial elastic recoil which causes slow relaxation and eventually increased ventricular stiffness, but its effect on systolic function is not entirely clear . Changes of ventricular systolic and diastolic functions can easily be studied by Doppler echocardiography which has shown age‐related lengthening of the isovolumic relaxation time (IVRT) that correlate with the decrease in early diastolic LV filling velocity (E wave) and the increase in atrial systolic velocity (A wave) .…”

Section: Introductionmentioning

confidence: 99%

The impact of age on cardiac electromechanical function in asymptomatic individuals

Vancheri¹,

Henein

2018

Echocardiography

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Background and Aim Whether aging affects left ventricular (LV) filling and ejection and the LV electric function is not well established. We investigated the effect of normal aging on echocardiographic measurements of LV morphology and function, LV electric function and the relationship between LV electric and mechanical function in asymptomatic individuals. Methods As part of a cross‐sectional survey for the prevalence of coronary risk factors in the general population in Caltanissetta, Italy, individuals without signs or symptoms of coronary artery disease or heart failure were randomly selected and underwent electrocardiographic and echocardiographic examination. QRS duration and amplitude, PR, QT and QTc intervals, were automatically measured. Echocardiographic examination included the measurement of LV systolic and diastolic dimensions, volumes and ejection fraction (EF). From the spectral Doppler flow LV early diastolic (E wave) and atrial systolic (A wave) velocities, isovolumic relaxation time (IVRT) and isovolumic contraction time (IVCT) were measured. Global LV dyssynchrony was assessed using the total isovolumic time (T‐IVT) and the Tei index. Results Aging reduced LV long‐axis function, LV filling time and E wave velocity and prolonged T‐IVT, IVRT and Tei index. It did not affect LV dimensions, ejection fraction, IVCT or QRS amplitude and duration. QRS duration correlated with LV dimensions, wall thickness and left atrial area. QRS amplitude and QTc interval correlated with the markers of LV dyssynchrony T‐IVT and Tei index. Conclusions Overall, systolic and electric LV function are not affected by age, whereas subendocardial function, diastolic and synchronous function are significantly influenced.

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Effect of age and sex on echocardiographic left ventricular diastolic function parameters in patients with preserved ejection fraction and normal valvular function

Abstract: (Cardiol J 2013; 20, 5: 513-518)

Cited by 21 publications

References 14 publications

Acute ascorbic acid infusion increases left ventricular diastolic function in postmenopausal women

Acute ascorbic acid infusion increases left ventricular diastolic function in postmenopausal women

Validation of Established Standard Values for the Correlation of E/e’ Ratio and Left Ventricular Diastolic Pressure in a Study of 190 Patients with Dyspnea– What are the Main Factors for the Observed Discrepancies?

The impact of age on cardiac electromechanical function in asymptomatic individuals

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