TY - JOUR
T1 - Left ventricular diastolic filling in the elderly
T2 - The cardiovascular health study
AU - Gardin, J. M.
AU - Arnold, A. M.
AU - Bild, D. E.
AU - Smith, V. E.
AU - Lima, J. A.C.
AU - Klopfenstein, H. S.
AU - Kitzman, D. W.
N1 - Funding Information:
This study was supported by contracts NO1-HC-85079 to HC-85086 from the National Heart, Lung, and Blood Institute, Bethesda, Maryland.
Funding Information:
The Cardiovascular Health Study (CHS) baseline cohort comprised 5,201 participants (2,239 men and 2,962 women). Of this cohort, 4,926 participants were white, 244 were black, and 31 were classified as “other nonwhite.” Ages ranged from 65 to 100 years (mean ± SD 73.3 ± 5.8 years in men and 72.4 ± 5.4 years in women). CHS participants were recruited and examined at 4 field centers: Forsyth County, North Carolina; Sacramento County, California; Allegheny County, Pennsylvania; and Washington County, Maryland. Overall design, objectives, and recruitment strategy of this study, initiated and supported by the National Heart, Lung, and Blood Institute, have been presented elsewhere. 15,16
Copyright:
Copyright 2007 Elsevier B.V., All rights reserved.
PY - 1998
Y1 - 1998
N2 - Changes in left ventricular (LV) diastolic function (e.g., as measured by transmitral flow velocity) are known to occur with aging. In addition, impaired LV diastulic function plays an important role in such cardiovascular disorders common in the elderly as hypertension, ischemic heart disease, and congestive heart failure (CHF). Participants in the Cardiovascular Health Study, a multicenter study of community-dwelling men (n = 2,239) and women (n = 2,962) ≤65 years of age, underwent an extensive baseline evaluation, including echocardiography. Early diastolic LV Doppler (transmitral) peak filling velocity decreased, and peak late diastolic (atrial) velocity increased with age in multivariate analyses (all p <0.001). Early and late diastolic peak filling velocities were both significantly higher in women than in men, even after adjustment for body surface area (or height and weight). In multivariate models in the entire cohort and a healthy subgroup (n = 703), gender, age, heart rate, and blood pressure (BP) were most strongly related to early and late diastolic transmitral peak velocities. Early and late diastolic peak velocities both increased with increases in systolic BP and decreased with increases in diastolic BP (p <0.001). Doppler transmitral velocities were compared among health status subgroups. In multiple regression models adjusted for other covariates, and in analysis of variance models examining-differences across subgroups adjusted only for age, the subgroup with CHF had the highest early diastolic peak velocities. All clinical disease subgroups had higher late diastolic peak velocities than the healthy subgroup, with the subgroups with either CHF or hypertension having the highest age-adjusted means. The subgroup with hypertension had the lowest ratio of early-to-late diastolic peak velocity, and men with CHF had the highest ratio. These findings are consistent with previous reports that hypertensive subjects exhibit an abnormal relaxation pattern, whereas patients with CHF develop a pattern suggestive of an increased early diastolic left atrial-LV pressure gradient.
AB - Changes in left ventricular (LV) diastolic function (e.g., as measured by transmitral flow velocity) are known to occur with aging. In addition, impaired LV diastulic function plays an important role in such cardiovascular disorders common in the elderly as hypertension, ischemic heart disease, and congestive heart failure (CHF). Participants in the Cardiovascular Health Study, a multicenter study of community-dwelling men (n = 2,239) and women (n = 2,962) ≤65 years of age, underwent an extensive baseline evaluation, including echocardiography. Early diastolic LV Doppler (transmitral) peak filling velocity decreased, and peak late diastolic (atrial) velocity increased with age in multivariate analyses (all p <0.001). Early and late diastolic peak filling velocities were both significantly higher in women than in men, even after adjustment for body surface area (or height and weight). In multivariate models in the entire cohort and a healthy subgroup (n = 703), gender, age, heart rate, and blood pressure (BP) were most strongly related to early and late diastolic transmitral peak velocities. Early and late diastolic peak velocities both increased with increases in systolic BP and decreased with increases in diastolic BP (p <0.001). Doppler transmitral velocities were compared among health status subgroups. In multiple regression models adjusted for other covariates, and in analysis of variance models examining-differences across subgroups adjusted only for age, the subgroup with CHF had the highest early diastolic peak velocities. All clinical disease subgroups had higher late diastolic peak velocities than the healthy subgroup, with the subgroups with either CHF or hypertension having the highest age-adjusted means. The subgroup with hypertension had the lowest ratio of early-to-late diastolic peak velocity, and men with CHF had the highest ratio. These findings are consistent with previous reports that hypertensive subjects exhibit an abnormal relaxation pattern, whereas patients with CHF develop a pattern suggestive of an increased early diastolic left atrial-LV pressure gradient.
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U2 - 10.1016/S0002-9149(98)00339-7
DO - 10.1016/S0002-9149(98)00339-7
M3 - Article
C2 - 9708665
AN - SCOPUS:0031927368
SN - 0002-9149
VL - 82
SP - 345
EP - 351
JO - American Journal of Cardiology
JF - American Journal of Cardiology
IS - 3
ER -