Abstract 748: Left Ventricular Dysfunction of Aging Despite Preserved LVEF Detected by 3D Echocardiography
Background: Preserved systolic left ventricular (LV) function with diastolic dysfunction has been reported in >50% of patients with heart failure (HF). Studies on normal ejection fraction (EF) HF have concentrated on Doppler diastolic filling parameters. We used real time 3D imaging to determine if previously undetected abnormalities in LV systolic function, LV emptying velocity and acceleration, represent left ventricular performance variables that change as patients age and may contribute to the increasing prevalence of HF in older patients.
Methods: We acquired high-resolution real time 3D echo images on unselected patients presenting for a clinically indicated transthoracic echo. Volume-time curves were generated with commercially available software and peak systolic emptying velocity (PSEV), peak systolic emptying acceleration (PSEA), and peak diastolic filling velocity (PDFV) were derived from the data sets. 3D LVEF was also measured.
Results: 50 patients, aged 19 –91, and LVEF > 45% were separated by age and analyzed. PSEV, PSEA, and PDFV all decreased with age (Figure⇓), despite no age related change in EF. Patients in the youngest age group had significantly faster systolic emptying velocity, systolic emptying acceleration, and diastolic filling velocity than patients in the oldest group.
Conclusion: Using real time 3D echo, we demonstrated that despite preserved LVEF, as patients age they develop subtle changes in these novel systolic performance variables as well as diastolic LV dysfunction. These measures of cardiac function may provide greater insight into the complex cardiac changes of aging hearts and may aid in the diagnosis of normal EF HF.