Age-Related Changes in Normal Human Hearts During the First 10 Decades of Life. Part II (Maturity): A Quantitative Anatomic Study of 765 Specimens From Subjects 20 to 99 Years Old
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METHODS
Specimens of normal hearts, from autopsies performed between 1960 and 1982, were obtained as previously described.21, 22 Specimens in which the severity of coronary atherosclerosis was grade 3 or 4 (that is, reduction of luminal cross-sectional area by more than 50%) were excluded from the study.
Among the available specimens, the most recently obtained hearts from 50 men and 50 women in each of the third through the ninth decades of life were reviewed. In the 10th decade, normal hearts were
RESULTS
Statistically significant age-related changes were identified for all cardiac measurements. Moreover, significant sex-dependent differences were identified for heart weights and valve circumferences but not for ventricular wall thicknesses.
DISCUSSION
Although numerous quantitative autopsy studies of normal cardiac dimensions have been published (Table 1),11, 12, 13, 14, 15, 16, 17, 18, 19, 20 to our knowledge only two such reports have included data concerning not only heart weight but also both ventricular wall thicknesses and valvular circumferences,14, 15 and none has included large numbers of specimens from elderly persons. In the current investigation, these three sets of measurements were recorded from 765 normal human hearts obtained
Heart Weight.
Heart weight is related to body size and may be predicted on the basis of body height, weight, or surface area. Mean heart weights in the current investigation (Table 2, Table 3) show excellent agreement (that is, less than 5% difference) with those in other studies based on body weight11 and height.12 Moreover, results of our study indicate that body weight and surface area are better univariate predictors of normal heart weight than is body height. When matched for age and body size, however,
Ventricular Wall Thicknesses.
In the current study, measurements of ventricular wall thicknesses for the third through seventh decades of life correspond well with those reported in adults by other investigators. The mean thickness of the right ventricular free wall was 3.8 mm (SD, 0.9 mm) in our study and 3.9 mm13 and 4.0 mm14, 15 in other studies, and that of the left ventricular free wall was 12.3 mm (SD, 1.6 mm) in the current investigation and 12.6 mm18 and 15.0 mm13, 15 in other reports. The mean ventricular septal
Valve Circumferences.
Cardiac valve circumferences, measured in autopsy specimens, have been published in four previous studies14, 15, 16, 20 and were reported to increase progressively with advancing age to the ninth decade of life.16 In the current investigation, the tendency of the aortic and pulmonary valves to dilate progressively with increasing age was clearly established. In fact, by the 10th decade of life, the circumference of the aortic valve approached that of the mitral valve. In contrast, the tricuspid
ACKNOWLEDGMENT
We thank Chu-Pin Chu, Department of Health Sciences Research, for help with the statistical analyses in this study.
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Current address: Duke University, Durham, North Carolina.