Reduced left ventricular systolic pump performance and depressed myocardial contractile function in patients &gt; 65 years of age with normal ejection fraction and a high relative wall thickness

Aurigemma, Gerard P.; Gaasch, William H.; McLaughlin, Michael; McGinn, Robert J.; Sweeney, Andrea; Meyer, Theo E.

doi:10.1016/s0002-9149(99)80201-x

Cited by 59 publications

(36 citation statements)

References 27 publications

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“…29,30 The significant relationships between midwall fractional shortening, meridional end-systolicstress and CVI found in the present study, represents a favourable element to the hypothesis that CVI could be considered as an index of intrinsic myocardial function, relatively sensitive to the afterload conditions. In this respect, we note that concentric LVH shows a higher impairment of the myocardial function, both with a lower CVI at septum and at posterior wall level and with a lower MFS, in comparison with other 'geometric subgroups'.…”

Section: Myocardial Midwall Mechanics and Ultrasonic Textural Parameterssupporting

confidence: 64%

Ultrasonic myocardial textural parameters and midwall left ventricular mechanics in essential arterial hypertension

et al. 2000

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Background: The evaluation of the systolic left ventricular performance in hypertensive patients presents some problems related to left ventricular hypertrophy (LVH) which alters the ventricular geometry. The videodensitometric textural ultrasonic analysis of hypertensive myocardium has provided evidence of impairment in the cyclic variation of the mean gray level. This might be considered as an index of intrinsic myocardial function. Objectives: The aim of the present study was to analyse the connection between the midwall fractional shortening and end-systolic stress. The ultrasonic textural parameters in hypertensive patients, arranged in different groups according to the level of LVH and relative wall thickness, were also evaluated. Methods: A group of age-matched (58 ؎ 7 years) male essential hypertensive patients (n ‫؍‬ 70) were compared to a group of normotensive and healthy subjects used as controls (n ‫؍‬ 32). All subjects performed a conventional 2D-Doppler echocardiography to analyse the left ventricular performance. A quantitative analysis of the echocardiographic digitised imaging was also carried out with the help of a calibrated digitisation system in order to calculate the septum and the posterior wall tex-

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Section: Myocardial Midwall Mechanics and Ultrasonic Textural Parameterssupporting

confidence: 64%

Ultrasonic myocardial textural parameters and midwall left ventricular mechanics in essential arterial hypertension

et al. 2000

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“…In our sample, the average stroke volume index and the E/A ratio were low; these findings together indicate a high prevalence of diastolic dysfunction, 28 especially as significant valvular lesions were excluded. Hence, older people may have a stiff left ventricle with an impaired diastolic filling, which in turn may give a high left ventricular ejection fraction if the systolic function is not disturbed.…”

Section: 3-5mentioning

confidence: 50%

Low blood pressure in the very old, a consequence of imminent heart failure: the Leiden 85-plus Study

et al. 2008

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Low blood pressure in the very old has been associated with organ dysfunction and excess mortality but the underlying mechanism has yet to be elucidated. We hypothesized that cardiac dysfunction contributes to low blood pressure in the very old. We invited a convenience sample consisting of 82 participants all aged 90 years from a population-based cohort study in the very old. Blood pressure was measured twice, and all but one underwent echocardiography to assess cardiac dimensions and functional cardiac parameters. Some 47 participants were free from haemodynamically significant valvular disease and were included in the present analyses.

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“…In response to pressure overload, as seen in aging with increased prevalence of hypertension,46 the ventricular wall thickens to normalize wall stress 45. As this process occurs, LVEF remains unaffected while myocardial shortening decreases 47. Before an increase in ventricular volume and onset of LV hypertrophy, the chamber volume can decrease, resulting in lower stroke volume47 and subsequently decreased CBF, as described earlier.…”

Section: Discussionmentioning

confidence: 67%

Subclinical Compromise in Cardiac Strain Relates to Lower Cognitive Performances in Older Adults

Kresge

Khan

Wagener

et al. 2018

JAHA

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BackgroundGlobal longitudinal strain (GLS), reflecting total shortening of the myocardium during the cardiac cycle, has emerged as a more precise myocardial function measure than left ventricular ejection fraction (LVEF). Longitudinal strain may be selectively affected in subclinical heart disease, even in the presence of normal LVEF. This study examines subclinical cardiac dysfunction, assessed by GLS and LVEF, and cognition among older adults.Methods and ResultsVanderbilt Memory and Aging Project participants who were free of clinical dementia, stroke, and heart failure (n=318, 73±7 years, 58% male) completed neuropsychological assessment and cardiac magnetic resonance to quantify GLS and LVEF. Linear regression models related GLS and LVEF to neuropsychological performances, adjusting for age, sex, race/ethnicity, education, Framingham Stroke Risk Profile, cognitive diagnosis, and APOE*ε4 status. Models were repeated with a cardiac×cognitive diagnosis interaction term. Compromised GLS (reflected by higher values) related to worse naming (β=−0.07, P=0.04), visuospatial immediate recall (β=−0.83, P=0.03), visuospatial delayed recall (β=−0.22, P=0.03), and verbal delayed recall (β=−0.11, P=0.007). LVEF did not relate to worse performance on any measure (P>0.18). No diagnostic interactions were observed.ConclusionsOur study results are among the first to suggest that compromised GLS relates to worse episodic memory and language performance among older adults who are free of clinical dementia, stroke, and heart failure. Subclinical cardiac dysfunction may correlate with cognitive health in late life, even when LVEF remains normal. The results add to growing evidence that GLS may be a more sensitive and preferred method for quantifying subclinical changes in cardiac function.

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Reduced left ventricular systolic pump performance and depressed myocardial contractile function in patients > 65 years of age with normal ejection fraction and a high relative wall thickness

Cited by 59 publications

References 27 publications

Ultrasonic myocardial textural parameters and midwall left ventricular mechanics in essential arterial hypertension

Ultrasonic myocardial textural parameters and midwall left ventricular mechanics in essential arterial hypertension

Low blood pressure in the very old, a consequence of imminent heart failure: the Leiden 85-plus Study

Subclinical Compromise in Cardiac Strain Relates to Lower Cognitive Performances in Older Adults

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