TY - JOUR
T1 - Age-associated changes in diastolic filling
T2 - Doppler E/A ratio is not associated with congestive heart failure in the elderly
AU - Marantz, Paul R.
AU - Tobin, Jonathan N.
AU - Derby, Carol A.
AU - Cohen, Michael V.
PY - 1994/7
Y1 - 1994/7
N2 - Although left ventricular filling tends to occur in late diastole in the elderly, the clinical significance of this change is unclear. To determine the prevalence of diastolic filling delay and its relationship to congestive heart failure (CHF) in the elderly, we studied 114 community-living elderly volunteers (median age 75, 37% male). Clinical history, physical examination, chest x-ray film, and Doppler echocardiogram were obtained in blinded fashion. CHF was diagnosed by a previously validated clinico- radiographic scoring system. Diastolic filling was assessed by the Doppler ratio of early to late transmitral flow velocity (E/A). The standard clinical definition of diastolic filling delay (E/A <1) was met by 94 subjects (82%), and median E/A was 0.72; for this study, diastolic filling delay was defined at the median, although both approaches yielded similar results. Systolic function was normal (ejection fraction >0.5) in 97%. There were 22 subjects (19%) with definite or possible CHF. Older subjects were more likely to have CHF, but not more likely to have an E/A ratio below the median. Subjects with diastolic filling delay were no more likely to have CHF than those without. Mean E/A was not different between CHF groups, and there was no significant correlation between E/A and CHF score. There was still no association after controlling for age, history of hypertension, and other potential confounders by multiple logistic regression. Although diastolic filling delay is common in the elderly, it does not correlate with signs and symptoms of CHF. Determination of its prognostic significance requires a prospective follow-up study.
AB - Although left ventricular filling tends to occur in late diastole in the elderly, the clinical significance of this change is unclear. To determine the prevalence of diastolic filling delay and its relationship to congestive heart failure (CHF) in the elderly, we studied 114 community-living elderly volunteers (median age 75, 37% male). Clinical history, physical examination, chest x-ray film, and Doppler echocardiogram were obtained in blinded fashion. CHF was diagnosed by a previously validated clinico- radiographic scoring system. Diastolic filling was assessed by the Doppler ratio of early to late transmitral flow velocity (E/A). The standard clinical definition of diastolic filling delay (E/A <1) was met by 94 subjects (82%), and median E/A was 0.72; for this study, diastolic filling delay was defined at the median, although both approaches yielded similar results. Systolic function was normal (ejection fraction >0.5) in 97%. There were 22 subjects (19%) with definite or possible CHF. Older subjects were more likely to have CHF, but not more likely to have an E/A ratio below the median. Subjects with diastolic filling delay were no more likely to have CHF than those without. Mean E/A was not different between CHF groups, and there was no significant correlation between E/A and CHF score. There was still no association after controlling for age, history of hypertension, and other potential confounders by multiple logistic regression. Although diastolic filling delay is common in the elderly, it does not correlate with signs and symptoms of CHF. Determination of its prognostic significance requires a prospective follow-up study.
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U2 - 10.1097/00007611-199407000-00011
DO - 10.1097/00007611-199407000-00011
M3 - Article
C2 - 8023206
AN - SCOPUS:0028321769
SN - 0038-4348
VL - 87
SP - 728
EP - 735
JO - Southern Medical Journal
JF - Southern Medical Journal
IS - 7
ER -