Elsevier

American Heart Journal

Volume 134, Issue 3, September 1997, Pages 426-434
American Heart Journal

Right and left ventricular diastolic function in patients with and without heart failure: Effect of age, sex, heart rate, and respiration on Doppler-derived measurements,☆☆

https://doi.org/10.1016/S0002-8703(97)70077-2Get rights and content

Abstract

Doppler echocardiography is widely used to assess right and left ventricular diastolic function. Although the factors affecting Doppler-derived measurements have been described in unaffected patients, there is little information available for patients with heart failure. Therefore we performed two-dimensional Doppler echocardiography studies of right and left ventricular function in 140 subjects, 88 with congestive heart failure and 52 age-matched normal subjects. The separate effects of age, sex, heart rate, and respiration were assessed by correlation analysis and multiple linear regression. In normal subjects both left and right ventricular parameters significantly correlated with age and heart rate. No significant effect of respiration was apparent in left ventricular function, but in the right ventricle inspiration caused a significant increase in transtricuspid peak E-wave velocity, E/A ratio, and shortening of the E-wave deceleration time. There was a significant correlation between left and right ventricular diastolic parameters. In heart failure, age correlated weakly with mitral valve peak A wave (r = 0.23, p = 0.03) and with tricuspid valve peak E-wave velocity (r = 0.37, p < 0.001), although in those with a restrictive filling pattern age was associated with a significant increased shortening of the mitral E-wave deceleration time (r = –0.8; p = 0.0015). Heart rate and deceleration time of mitral and tricuspid E wave significantly correlated, but heart rate did not correlate with either mitral or tricuspid peak E-wave or A-wave velocities or E/A ratio. In heart failure the effect of respiration was similar to normal subjects. Sex was not associated with Doppler variables in either normals or heart failure subjects. Thus this study demonstrates that age, heart rate, and respiration have important and separate associations with Doppler echo diastolic parameters of the right and left ventricle in normal subjects and similar, although weaker relations in patients with heart failure. (Am Heart J 1997;134:426-34.)

Section snippets

Subjects

One hundred and forty subjects were recruited for the study. They consisted of two groups: patients with typical congestive heart failure and normal subjects.

Normal subjects

There was a significant correlation between LV diastolic parameters and age (Table I) . With increasing age, the mitral valve (MV) E wave decreased while the MV A wave increased, causing a modest decrease in MV E/A ratio and lengthening of LV IVRT. Similar observation was found in the right heart, although there was no significant effect on tricuspid valve (TV) A-wave velocity.

Heart failure

In patients with heart failure, the only positive correlation with increasing age in the LV was with the MV A wave (

Age and diastolic function

The effects of age on diastolic parameters in normal subjects have been noted by several investigators. However, the exact effect of age on different Doppler-identified measurements remains controversial. Iwase et al.10 and Zoghbi et al.8 described a group of normal subjects in which both mitral and tricuspid E-wave velocity and E/A ratio decreased with increasing age, whereas the A-wave velocity increased. However, Berman et al.6 found that mitral E wave did not correlate with age, whereas Pye

Acknowledgements

We thank Mrs. Anastasia Gates for typing the manuscript.

References (18)

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Reprint requests: John E. Sanderson, MD, Department of Medicine, The Chinese University of Hong Kong, 9/F Clinical Sciences Bldg., Prince of Wales Hospital, Shatin, N.T., Hong Kong, China.

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