Abstract
Purpose
The number of patients aged over 90 years undergoing transthoracic echocardiography (TTE) has increased. Normal echocardiographic measurement values in healthy Japanese aged 20–79 years have been reported by Daimon et al., and in those aged 10–89 years by Okura et al. To date, no researchers have published normal values in healthy Japanese aged over 90 years. To understand the echocardiographic characteristics and establish the normal range, we evaluated patients aged over 90 years who had preserved left ventricular (LV) ejection fraction without cardiovascular disease.
Method
Enrolled in the study were consecutive patients aged over 90 years who were examined by TTE at the Ultrasound Imaging Center at Nagasaki University Hospital, Japan, between September 2009 and May 2016. We selected patients with LV ejection fraction > 55%, and without cardiac, renal, or aortic disease.
Results
Among a total of 956 patients, 73 patients (19 males, 54 females) were admitted. Compared with females, males had significantly higher values of aortic diameter at the sinus of Valsalva and LV diastolic diameter and systolic diameter (P < 0.01), significantly lower E wave velocities (P < 0.01) and left ventricle mass (P < 0.01), and lower values of relative wall thickness (P < 0.01). Compared with subjects in their 70s and 80s in the studies by Daimon and Okura, the E and A wave velocities were higher.
Conclusion
We established the normal range of TTE parameters in elderly patients who had LV ejection fraction > 55% without cardiac, renal, or aortic disease. Sex differences were present as well as a tendency towards age-related changes in LV geometry and diastolic function. Most of the patients aged over 90 years had LV hypertrophy and potential diastolic dysfunction.
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References
Daimon M, Watanabe H, Abe Y, et al. Normal value of echocardiographic parameters in relation to age in a healthy Japanese population—the JAMP study. Circ J. 2008;72:1859–66.
Munagala VK, Jacobson SJ, Mahoney DW, et al. Association of newer diastolic function parameters with age in healthy subjects: a population-based study. J Am Soc Echocardiogr. 2003;16:1049–56.
Mantero A, Gentile F, Gualtierotti C, et al. Left ventricular diastolic parameters in 288 normal subjects from 20 to 80 years old. Eur Heart J. 1995;1:94–105.
Kou S, Caballero L, Doulgheru R, et al. Echocardiographic reference ranges for normal cardiac chamber size: results from NORRE study. Eur Heart J Cardiovasuc Imaging. 2014;15:680–90.
Innelli P, Sanchez R, Marra F, et al. The impact of aging on left ventricular longitudinal function in healthy subjects: a pulsed tissue Doppler study. Eur J Echocardiogr. 2008;9:241–9.
Miyatake K, Okamoto M, Kinoshita N, et al. Augumentation of atrial contribution to left ventricular inflow with aging as assessed by intracardiac Doppler flowmetry. Am J Cardiol. 1984;53:586–9.
Okura H, Takada Y, Yamabe A, et al. Age-and gender-specific changes in the left ventricular relaxation a Doppler echocardiographic study in healthy individuals. Circ Cardiovasc Imaging. 2009;10:246–70.
Daimon M, Watanabe H, Abe Y, et al. Gender differences in age-related changes in left anr right ventricular geometries and functions—echocardiography of healthy subject group. Circ J. 2011;75:2840–6.
Tomita A, Miyamoto S, Horikoshi T. Body surface area of Japanese young males and females. Jpn J Biometeorol. 1999;36:43–51.
Lang RM, Badano LP, Mori-Avi V, et al. Recommendations for cardiac chamber quantification by echocardiography in adults: an update from the American Society of Echocardiography and the European Association of Cardiovascular Imaging. JASE. 2015;16:233–70.
Kanda Y. Investigation of the freely available easy-to-use software ‘EZR’ for medical statistics. Bone Marrow Transplant. 2013;48:452–8.
Lang RM, Bierig M, Devereux RB, et al. Recommendations for chamber quantification. J Am Soc Echocardialogr. 2005;18:1440–63.
El Missiri A, El Meniawy K, Sakr S, et al. Normal reference values of echocardiographic measurements in young Egyptian adults. Egypt Soc Cardiol. 2016;68:209–15.
Safak O, Gursoy O, Karakoyun S, et al. Normal echocardiographic measurements in a Turkish population: the healthy Heart ECHO-TR trial. Anatol J Cardiol. 2019;22:262–70.
Mohammed SF, Mirzoyev SA, Edwards WD, et al. Left ventricular amyloid deposition in patients with heart failure and preserved ejection fraction. JACC Heart Fail. 2014;2:113–122.
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Minami, T., Kawano, H., Sato, D. et al. Evaluation of echocardiographic parameters in Japanese patients aged over 90 years at a single institution. J Med Ultrasonics 47, 555–563 (2020). https://doi.org/10.1007/s10396-020-01036-4
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DOI: https://doi.org/10.1007/s10396-020-01036-4