Effect of Age and Pathology on Left Ventricular Diastolic Function: The Diagnostic Yield of Doppler Echocardiography

Background. Doppler echocardiography has been proposed to detect left ventricular (LV) diastolic dysfunction in the elderly. However, the validity of this technique in differentiating the effects of pathology from those of normal aging has not been defined. Methods. Doppler indices of LV diastolic function were obtained in 85 patients (34 hypertensive, 29 with coronary artery disease, 22 with both conditions) and in 56 healthy volunteers. Results. A iinear correlation with age was found for all parameters in controls, and for many parameters in patients. Also, in the presence of heart diseases, age exerted a powerful, independent effect on Doppler parameters. None of these differed between patients and controls in advanced age. Conclusion. Due to the prevailing age-related variations in Doppler indices of diastolic performance occurring beyond the age of 65, Doppler echocardiography cannot be employed to diagnose LV diastolic dysfunction in the elderly. DOPPLER echocardiography has proved a useful tool inthe noninvasive evaluation of left ventricular (LV) diastolic filling (1). Abnormalities of diastolic performance have been demonstrated in patients with various cardiac diseases (2,3). In addition, indices of LV filling have been found to be strongly affected by age (4). Therefore, the need for age-corrected nomograms of Doppler diastolic function parameters has been emphasized by many authors (4-7). Given the high prevalence of congestive heart failure with normal systolic LV function among the elderly (8-10), the availability of a noninvasive tool to detect diastolic dysfunc-tion, such as Doppler echocardiography, would be crucial. To this purpose, the method should allow to differentiate the effects of diseases from those of normal aging. In order to ascertain whether Doppler echocardiography may fulfill this requirement, we compared the isovolumic relaxation period and the early and late LV filling phases in a normal population and in patients with chronic hypertensive and/or coronary heart disease