, Volume 22, Issue 5, pp 633-641
Date: 16 Mar 2006

Echocardiographically estimated left ventricular end-diastolic and right ventricular systolic pressure in normotensive healthy individuals

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Abstract

Aim

To study the effect of aging on and the relationship between echocardiographically estimated left ventricular (LV) filling pressure and estimated right ventricular (RV) systolic pressure among healthy normotensive individuals.

Methods

We analyzed 249 healthy individuals (aged 18–82 years, 52% men) with normal echocardiographic findings and reliably measurable tricuspid regurgitation gradients. Subjects with blood pressure >140/90 mmHg and/or LV hypertrophy were excluded. LV & RV dimensions and LV mass were measured with M-mode echocardiography. Atrial (A) volumes were determined with the area-length method. Diastolic function was assessed with transmitral Doppler and mitral annulus tissue Doppler. The ratio of transmitral early peak velocity to early diastolic mitral annulus velocity (E/E′) was used as estimation of LV filling pressure. The transtricuspid Doppler gradient was used to estimate RV end-systolic pressure.

Results

Even in normotensive individuals aging was accompanied by an increase in LV mass and LA dimensions and an increase in relaxation abnormalities. E/E′ increased with every decade: from 7.8 for age 18–35 years to 10.9 for age ≥75 years (p<0.0001) as did the transtricuspid gradient: from 18.3 mmHg for age 18–35 years to 25.8 mmHg for age ≥75 years (p<0.0001). Linear regression showed that estimated RV systolic pressure was independently predicted by age, LA volume, LV systolic function and E/E′.

Conclusion

Among normotensive healthy individuals both E/E′ and tricuspid regurgitation gradients increase significantly with aging. Moreover the E/E′ ratio was independently predicting the tricuspid regurgitation gradient. These findings support the need for further studies defining age specific normal values.