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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.

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Abbreviations

A:

late transmitral flow velocity

DT:

deceleration time

E :

transmitral early peak velocity

E′:

early diastolic mitral annulus velocity

FS:

fractional shortening

IVSD:

end-diastolic interventricular septum wall thickness

L:

left

LA:

left atrial

LAD:

left atrial diameter

LAV:

left atrial volume

LV:

left ventricular

LVEDD:

left ventricular end-diastolic diameter

LVESD:

left ventricular end-systolic diameter

PWD:

end-diastolic posterior wall thickness

R:

right

RA:

right atrial

RAV:

right atrial volume

RV:

right ventricular

RVEDD:

right ventricular end-diastolic diameter

TAPSE:

tricuspid annular plane systolic excursion

References

  1. Oh J (2005) Echocardiography as a noninvasive Swan-Ganz Catheter. Circulation 111: 3192–3194

    Article  PubMed  Google Scholar 

  2. Yock P, Popp R (1984) Noninvasive estimation of right ventricular systolic pressure by Doppler ultrasound in patients with tricuspid regurgitation. Circulation 10:657–662

    Google Scholar 

  3. Berger M, Haimowitz A, Van Tosh A, Berdoff R, Goldberg E (1985) Quantitative assessment of pulmonary hypertension in patients with tricuspid regurgitation using continuous wave Doppler ultrasound. J Am Coll Cardiol 6:359–365

    PubMed  CAS  Google Scholar 

  4. Currie P, Seward J, Chan K-L, et al. (1985) Continuous wave Doppler determination of right ventricular pressure: a simultaneous Doppler-Catheterization study in 127 patients. J Am Coll Cardiol 6: 750–756

    Article  PubMed  CAS  Google Scholar 

  5. Nagueh S, Middleton F, Kopelen H, Zoghbi W, Quinones M (1997) Doppler tissue imaging: a nonivasive technique for evaluation of left ventricular relaxation and estimation of filling pressures. J Am Coll Cardiol 30:1527–1533

    Article  PubMed  CAS  Google Scholar 

  6. Redfield M, Jacobson S, Burnett J, Mahoney D, Bailey K, Rodeheffer R (2003) Burden of systolic and diastolic ventricular dysfunction in the community. Appreciating the scope of the heart failure epidemic. JAMA 289:194–202

    Article  PubMed  Google Scholar 

  7. Ommen S, Nishimura R, Appleton C, et al. (2000) The clinical utility of Doppler echocardiography and tissue Doppler imaging in estimation of left ventricular filling pressures: a comparative simultaneous Doppler-catheterization study. Circulation 102: 1788–1794

    PubMed  CAS  Google Scholar 

  8. Lakatta E, Levy D (2003) Arterial and cardiac aging: Major shareholders in cardiovascular disease enterprises. Part II: The aging heart in health: links to heart disease. Circulation 107: 346–354

    Article  PubMed  Google Scholar 

  9. Berman G, Reichek N, Brownson D, Douglas P (1990) Effects of sample volume location, imaging view, heart rate and age on tricuspid velocimetry in normal subjects. Am J Cardiol 65: 1025–1030

    Article  Google Scholar 

  10. Dib J-C, Abergel E, Rovani C, Raffoul H, Diebold B (1997) The age of the patient should be taken into account when interpreting Doppler assessed pulmonary artery pressures. J Am Soc Echocardiogr 10: 72–73

    Article  PubMed  CAS  Google Scholar 

  11. Aessopos A, Farmakis D, Taktikou H, Loukopoulos H (2000) Doppler-determined peak systolic tricuspid pressure gradient in persons with normal pulmonary function and tricuspid regurgitation. J Am Soc Echocardiogr 13: 645–649

    Article  PubMed  CAS  Google Scholar 

  12. McQuillan B, Picard M, Leavitt M, Weyman A (2001) Clinical correlates and reference intervals for pulmonary artery systolic pressure among echocardiographically normal subjects. Circulation 104: 2797–2802

    PubMed  CAS  Google Scholar 

  13. Echocardiography-based left ventricular mass estimation. How should we define hypertrophy? Cardiovascular Ultrasound 2005; 3: 17

  14. Gottdiener J, Diamond J, Philips R (2002) Hypertension, impact on echocardiographic data on the mechanisms of hypertension, treatment options, prognosis and assessment of therapy. In: Otto CM, (eds), The Practice of Clinical Echocardiography. Saunders, Philadelphia, pp. 705–738

    Google Scholar 

  15. Kaul S, Tei C, Hopkins JM, Shah PM (1984) Assessment of right ventricular function using two dimensional echocardiography. Am Heart J 107: 526–531

    Article  PubMed  CAS  Google Scholar 

  16. Arbab-Zadeh A, Dijk E, Prasad A, Fu Q, Torres P, Zhang R, Thomas J, Palmer D, Levine B (2004) Effect of aging and physical activity on left ventricular compliance. Circulation 110:1799–1805

    Article  PubMed  Google Scholar 

  17. Shub C, Klein A, Zachariah P, Bailey T, Tajik A (1994) Determination of left ventricular mass by echocardiography in a normal population: effect of age and sex in addition to body size. Mayo Clin Proc 69:205–211

    PubMed  CAS  Google Scholar 

  18. Klein A, Burstow D, Tajik A, Zachariah P, Bailey K, Seward J (1994) Effects of age on left ventricular dimensions and filling dynamics in 117 normal persons. Mayo Clin Proc 69: 212–224

    PubMed  CAS  Google Scholar 

  19. De Sutter J, De Backer J, Van de Veire N, Velghe A, De Buyzere M, Gillebert TC (2005) Effects of age, gender, and left ventricular mass on septal mitral annulus velocity (E′) and the ratio of transmitral early peak velocity to E′ (E/E′). Am J Cardiol 95: 1020–1023

    Article  PubMed  Google Scholar 

  20. Mungala V, Jacobsen S, Mahoney D, Rodeheffer R, Bailey K, Redfield M (2003) Association of newer diastolic function parameters with age in healthy subjects: a population-based study. J Am Soc Echocardiogr 16: 1049–1056

    Article  Google Scholar 

  21. Schnittiger I, Gordon E, Fitzgerald P, Popp R (1983) Standardized intracardiac measurements of two-dimensional echocardiography. J Am Coll Cardiol 2: 934–938

    Article  Google Scholar 

  22. Bossone E, Rubenfire M, Bach D, Ricciardi M, Armstrong W (1999) Range of tricuspid regurgitation velocity at rest and during exercise in normal adult men: implications for the diagnosis of pulmonary hypertension. J Am Coll Cardiol 33: 1662–1666

    Article  PubMed  CAS  Google Scholar 

  23. Dokainish H, Gin K, Lee P-K, Jue J (2003) Left ventricular filling patterns and pulmonary artery pressures in patients aged 90 to 100 years with normal echocardiography results. J Am Soc Echocardiogr 16: 664–669

    Article  PubMed  Google Scholar 

  24. Dincer I, Kumbasar D, Nergisoglu G, et al. Assessment of left ventricular diastolic function with Doppler tissue imaging: Effects of preload and place of measurements. Int J Cardiovasc Imaging 2002; 155–160

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Acknowledgements

Nico Van de Veire is a research assistant and Johan De Sutter a senior clinical investigator of the Fund for Scientific Research Flanders – Belgium (F.W.O.-Vlaanderen). Julie De Backer is a recipient of a BOF mandate at Ghent University, Belgium. The authors would like to thank Krista Van Vlaenderen (M.Eng) for her technical assistance.

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Authors and Affiliations

  1. Departments of Cardiology, Ghent University, Ghent, Belgium

    Nico R. Van de Veire, Julie De Backer, An-Kristin Ascoop, Bart Middernacht & Johan De Sutter

  2. Departments of Geriatrics, Ghent University, Ghent, Belgium

    Anja Velghe

  3. Department of Cardiology, University Hospital, De Pintelaan 185, 9000, Gent, Belgium

    Nico R. Van de Veire

Authors
  1. Nico R. Van de Veire
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  2. Julie De Backer
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  3. An-Kristin Ascoop
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  4. Bart Middernacht
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  5. Anja Velghe
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  6. Johan De Sutter
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Correspondence to Nico R. Van de Veire.

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Van de Veire, N.R., De Backer, J., Ascoop, AK. et al. Echocardiographically estimated left ventricular end-diastolic and right ventricular systolic pressure in normotensive healthy individuals. Int J Cardiovasc Imaging 22, 633–641 (2006). https://doi.org/10.1007/s10554-006-9082-y

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  • DOI: https://doi.org/10.1007/s10554-006-9082-y

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