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Longitudinal myocardial dysfunction in healthy older subjects as a manifestation of cardiac ageing

Nikitin, Nikolay P.; Witte, Klaus K.A.; Ingle, Lee; Clark, Andrew L.; Farnsworth, T. Alan; Cleland, John G.F.


Nikolay P. Nikitin

Klaus K.A. Witte

Andrew L. Clark

T. Alan Farnsworth

John G.F. Cleland


Background: Abnormalities of longitudinal left ventricular (LV) contraction and relaxation may be early markers of cardiac disease. This study was designed to assess the relationship between long-axis LV function and age in healthy subjects. Methods: 118 healthy individuals aged 57 ±19 years (range 20-90 years) with no evidence of cardiovascular disease under-went echocardiography with Doppler examination of transmitral flow. To assess longitudinal LV function, systolic (S m ), early diastolic (E m ) and late diastolic (A m ) mitral annular velocities were measured using colour-coded tissue Doppler imaging. Results: The left atrium was enlarged (P < 0.001) in subjects ≥60 years of age compared to those < 60 years, but there were no differences in LV volumetric indices and ejection fraction. Peak E velocity was lower (P < 0.001) and peak A velocity of transmitral flow was higher in older subjects (P < 0.001) with a higher E/A ratio (P < 0.001) and longer isovolumic relaxation time (P = 0.001) indicative of impaired ventricular relaxation. S m and E m mitral annular velocities decreased (P < 0.001) and A m velocity increased (P = 0.002) in the older group. E m velocity and E m /A m ratio showed a strong negative correlation with age (r = -0.80, P < 0.001 and r = -0.78, P < 0.001, respectively). Conclusions: Global LV systolic function is preserved but the velocity of long-axis systolic shortening is depressed in older individuals, indicating selective impairment of the longitudinal component of systolic contraction. The decline in the velocity of early diastolic long-axis LV lengthening and the changes in the pattern of transmitral flow suggest impaired ventricular relaxation. These measures of cardiac function may be a useful index of normal cardiac ageing. © The Author 2005. Published by Oxford University Press. All rights reserved.


Nikitin, N. P., Witte, K. K., Ingle, L., Clark, A. L., Farnsworth, T. A., & Cleland, J. G. (2005). Longitudinal myocardial dysfunction in healthy older subjects as a manifestation of cardiac ageing. Age and ageing, 34(4), 343-349.

Journal Article Type Article
Acceptance Date Dec 6, 2004
Online Publication Date Feb 25, 2005
Publication Date 2005-07
Deposit Date May 7, 2019
Journal Age and Ageing
Print ISSN 0002-0729
Electronic ISSN 1468-2834
Publisher Oxford University Press (OUP)
Peer Reviewed Peer Reviewed
Volume 34
Issue 4
Pages 343-349
Keywords Ageing; Ventricular function; Left, systole; Diastole; Echocardiography; Doppler; Elderly; Longitudinal myocardial dysfunction; Cardiac ageing
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