Age dependency of left ventricular diastolic function in pressure overload hypertrophy

Détails

ID Serval
serval:BIB_7F4CC99DC856
Type
Article: article d'un périodique ou d'un magazine.
Collection
Publications
Institution
Titre
Age dependency of left ventricular diastolic function in pressure overload hypertrophy
Périodique
Journal of the American College of Cardiology
Auteur(s)
Villari  B., Vassalli  G., Schneider  J., Chiariello  M., Hess  O. M.
ISSN
0735-1097 (Print)
Statut éditorial
Publié
Date de publication
01/1997
Volume
29
Numéro
1
Pages
181-6
Notes
Comparative Study
Journal Article --- Old month value: Jan
Résumé
OBJECTIVES: We sought to evaluate whether age is a determinant of left ventricular (LV) pressure overload hypertrophy and whether diastolic function influenced the aging process. BACKGROUND: The adaptation of the left ventricle to chronic pressure overload is a complex process of hormonal, structural and hemodynamic factors. Different responses in the elderly patients have been described. METHODS: LV biplane cineangiography, micromanometry and endomyocardial biopsies were carried out in 57 patients with pure or predominant aortic stenosis. Patients were classified into a senior (< 60 years, mean age +/- SD 46 +/- 10 years, n = 35) and an elderly (< 65 years; mean age 70 +/- 4 years, n = 22) study group. LV systolic function was evaluated from biplane ejection fraction and midwall fractional shortening, whereas diastolic function was assessed from the time constant of LV pressure decay, peak filling rate and the constant of myocardial stiffness. Biopsy samples were examined morphometrically for interstitial fibrosis, fibrous content, muscle fiber diameter and volume fraction of myofibrils. RESULTS: Gender distribution and the severity of aortic stenosis were comparable in the two patient groups. LV peak systolic and end-diastolic pressures were significantly higher in the elderly than in the senior group. LV ejection fraction and midwall fractional shortening were comparable in the two groups. The time constant of relaxation and the myocardial stiffness constant were greater in the elderly than in the senior group whereas the early peak filling rate was significantly reduced in the elderly group. Interstitial fibrosis was increased, although not significantly (p < 0.06), and fibrous content was enhanced (p < 0.001) in elderly patients with respect to the senior group. There was a linear correlation between age and myocardial stiffness (r = 0.55), p < 0.0001) and an inverse relation between age and early peak filling rate (r = 0.52, p < 0.0001). CONCLUSIONS: In the presence of a comparable degree of aortic valve stenosis, elderly patients (> 65 years) present with more severe LV hypertrophy than do senior patients (< 60 years). Therefore elderly patients have a more pronounced impairment of LV diastolic function, whereas systolic function is preserved. Thus, there is an age dependency of LV pressure overload hypertrophy that can be explained by the longer duration of pressure overload or an exhaustion of the adaptation process in the elderly.
Mots-clé
Adaptation, Physiological/physiology Age Factors Aged Aging/*physiology Aortic Valve Stenosis/complications/*physiopathology Case-Control Studies Female Heart Catheterization Humans Hypertrophy, Left Ventricular/diagnosis/etiology/*physiopathology Male Middle Aged Myocardial Contraction/physiology Ventricular Function, Left/*physiology
Pubmed
Web of science
Création de la notice
28/01/2008 10:32
Dernière modification de la notice
20/08/2019 14:40
Données d'usage