Abstract 2437: The Interaction between Left Ventricular Apical Rotation and the Arterial Blood Pressure in Elderly Females may Reveal Mechanisms Involved in the Syndrome of Diastolic Heart Failure a Follow-Up Study
LV apical short-axis loops were obtained with 2D echocardiography (80 – 110 frames/s) in 31 healthy females, age 69 to 84 years. Peak apical rotation (PAR) and peak rotation velocity (PAR-velocity) was assessed with speckle tracking (ST). Ambulatory systolic (SBP) and diastolic (DBP) blood pressures were averaged between 0600 and 2300. The difference (Δ) between measurements after four years follow-up was calculated by subtracting the first from the last assessment. Apical short-axis loops were eligible for ST in 27 subjects. SBP and DBP increased (126 ± 14 vs 133 ± 13 mm Hg, p = 0.007 and 70 ± 7 vs 73 ± 7 mm Hg, p = 0.049) and LV end-diastolic and end-systolic volumes decreased (84 ± 15 vs 74 ± 10 ml, p < 0.0001 and 33 ± 9 vs 25 ± 7 ml, p < 0.0001) during follow-up. ΔSBP and ΔDBP correlated inversely with the LV end-diastolic short-axis dimension (r = −0.38, p = 0.03 and r = −0.43, p = 0.02). ΔSBP, ΔDBP and DBP, correlated inversely with PAR (r = −0.51, p = 0.007; r = −0.59, p = 0.0001 and r = −0.47, p = 0.01). PAR correlated positively with LV stroke volume and with body weight (p < 0.05) and with systolic and diastolic PAR-velocity (r = 0.76, p < 0.0001 and r = 0.58, p = 0.001). Diastolic PAR-velocity correlated with mitral E peak velocity (r = 0.48, p = 0.01). In healthy elderly females LV peak apical rotation and peak diastolic rotation velocity correlate with indices of LV filling and ejection, indicating that suction, a key property for effective early LV filling, may be preserved in elderly subjects. Suction seems to deteriorate with BP elevations. An age- or blood pressure related reduction in LV end-diastolic volume may represent an additional impediment to LV filling. Both features may contribute to the development of LV diastolic dysfunction and to diastolic heart failure.