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Increased myocardial dysfunction, dyssynchrony, and epicardial fat across the lifespan in healthy males.

Crendal E, Dutheil F, Naughton G, McDonald T, Obert P - BMC Cardiovasc Disord (2014)

Bottom Line: Moreover, independent of blood biology, significant increases were observed across age categories for EAT (young: 2.5 ± 0.9 mm, middle: 3.9 ± 1.0 mm, older 5.7 ± 2.4 mm; p < 0.01), longitudinal STE-dyssynchrony (young: 42 ± 7.7 ms, middle: 58.8 ± 18.9 ms, older 88.6 ± 18.2 ms; p < 0.05), and circumferential-basal STE-dyssynchrony (young: 50.2 ± 20.5 ms, middle: 75.9 ± 20.6 ms, older 97.9 ± 20.2 ms; p < 0.05).This study enabled comprehensive profiling of LV mechanics at different stages of aging using sensitive echocardiographic technology.These factors may be key underlying contributors to myocardial dysfunction during aging, and their recognition may promote an advanced understanding of early signs of cardiovascular disease.

View Article: PubMed Central - HTML - PubMed

Affiliation: School of Exercise Science, Australian Catholic University, Locked Bag 4115, Fitzroy, MDC Victoria 3065, Australia. edwardcrendal@gmail.com.

ABSTRACT

Background: Evaluation of sensitive myocardial mechanics with speckle tracking echocardiography (STE) across the lifespan may reveal early indicators of cardiovascular disease (CVD) risk. Epicardial adipose tissue (EAT) and left ventricular (LV) myocardial dyssynchrony; subclinical risk-factors of CVD, are of particular clinical interest. However, the evolution of EAT and LV-dyssynchrony across the lifespan, and their influence on myocardial dysfunction remains unclear. We aimed to establish a profile of the healthy aging-heart using conventional, tissue-Doppler imaging (TDI) and speckle-tracking echocardiography (STE), while also exploring underlying contributions from EAT and LV-dyssynchrony towards LV myocardial mechanics, independent of blood biology.

Methods: Healthy males aged 19-94 years were recruited through University-wide advertisements in Victoria and New-South Wales, Australia. Following strict exclusion criteria, basic clinical and comprehensive echocardiographic profiles (conventional, TDI and STE) were established. LV-dyssynchrony was calculated from the maximum-delay of time-to-peak velocity/strain in the four LV-annulus sites (TDI), and six LV-segments (STE longitudinal and circumferential axes). Epicardial fat diameter was obtained from two-dimensional grey-scale images in the parasternal long-axis. Blood biological measures included glycemia, hsCRP, triglycerides, total cholesterol, high-density and low-density lipoprotein levels.

Results: Three groups of 15 were assigned to young (<40 years), middle (40-65 years), and older (>65) aged categories. Five participants were excluded from STE analyses due to inadequate image quality. Decreased longitudinal strain, increased circumferential apical strain and LV twist were age-related. Moreover, independent of blood biology, significant increases were observed across age categories for EAT (young: 2.5 ± 0.9 mm, middle: 3.9 ± 1.0 mm, older 5.7 ± 2.4 mm; p < 0.01), longitudinal STE-dyssynchrony (young: 42 ± 7.7 ms, middle: 58.8 ± 18.9 ms, older 88.6 ± 18.2 ms; p < 0.05), and circumferential-basal STE-dyssynchrony (young: 50.2 ± 20.5 ms, middle: 75.9 ± 20.6 ms, older 97.9 ± 20.2 ms; p < 0.05). These variables collectively explained 37% and 31% (p < 0.01) of longitudinal strain and LV twist, respectively.

Conclusions: This study enabled comprehensive profiling of LV mechanics at different stages of aging using sensitive echocardiographic technology. Novel findings included increased epicardial fat, and both longitudinal and circumferential LV-dyssynchrony across the healthy age groups. These factors may be key underlying contributors to myocardial dysfunction during aging, and their recognition may promote an advanced understanding of early signs of cardiovascular disease.

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Data are means ± standard deviations. Left ventricular dyssynchrony derived from STE or TDI across the lifespan in healthy males. STE: Speckle tracking echocardiography. TDI: Tissue Doppler imaging. L: Longitudinal. C: Circumferential (basal level). *: p < 0.05 vs. Young; ***: p < 0.001 vs. Young; #: p < 0.05 vs. Middle; ###: p < 0.001 vs. Middle.
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Figure 2: Data are means ± standard deviations. Left ventricular dyssynchrony derived from STE or TDI across the lifespan in healthy males. STE: Speckle tracking echocardiography. TDI: Tissue Doppler imaging. L: Longitudinal. C: Circumferential (basal level). *: p < 0.05 vs. Young; ***: p < 0.001 vs. Young; #: p < 0.05 vs. Middle; ###: p < 0.001 vs. Middle.

Mentions: Measures of LV-dyssynchrony across the age groups are presented in Figure 2. Both TDI-derived systolic and diastolic maximum delay were greater in O than Y (p < 0.05). TDI-derived maximum delay did not differ between O and M, nor M and Y. In contrast, STE-derived longitudinal maximum delay was greater in O than both M and Y (p < 0.001), while also greater in M than Y (p < 0.05). Additionally, STE-derived circumferential maximum delay at the base was greater in O than both M and Y (p < 0.05), while also greater in M than Y (p < 0.05). No inter-group differences existed for STE-derived circumferential maximum delay at the apex.


Increased myocardial dysfunction, dyssynchrony, and epicardial fat across the lifespan in healthy males.

Crendal E, Dutheil F, Naughton G, McDonald T, Obert P - BMC Cardiovasc Disord (2014)

Data are means ± standard deviations. Left ventricular dyssynchrony derived from STE or TDI across the lifespan in healthy males. STE: Speckle tracking echocardiography. TDI: Tissue Doppler imaging. L: Longitudinal. C: Circumferential (basal level). *: p < 0.05 vs. Young; ***: p < 0.001 vs. Young; #: p < 0.05 vs. Middle; ###: p < 0.001 vs. Middle.
© Copyright Policy - open-access
Related In: Results  -  Collection

License 1 - License 2
Show All Figures
getmorefigures.php?uid=PMC4125345&req=5

Figure 2: Data are means ± standard deviations. Left ventricular dyssynchrony derived from STE or TDI across the lifespan in healthy males. STE: Speckle tracking echocardiography. TDI: Tissue Doppler imaging. L: Longitudinal. C: Circumferential (basal level). *: p < 0.05 vs. Young; ***: p < 0.001 vs. Young; #: p < 0.05 vs. Middle; ###: p < 0.001 vs. Middle.
Mentions: Measures of LV-dyssynchrony across the age groups are presented in Figure 2. Both TDI-derived systolic and diastolic maximum delay were greater in O than Y (p < 0.05). TDI-derived maximum delay did not differ between O and M, nor M and Y. In contrast, STE-derived longitudinal maximum delay was greater in O than both M and Y (p < 0.001), while also greater in M than Y (p < 0.05). Additionally, STE-derived circumferential maximum delay at the base was greater in O than both M and Y (p < 0.05), while also greater in M than Y (p < 0.05). No inter-group differences existed for STE-derived circumferential maximum delay at the apex.

Bottom Line: Moreover, independent of blood biology, significant increases were observed across age categories for EAT (young: 2.5 ± 0.9 mm, middle: 3.9 ± 1.0 mm, older 5.7 ± 2.4 mm; p < 0.01), longitudinal STE-dyssynchrony (young: 42 ± 7.7 ms, middle: 58.8 ± 18.9 ms, older 88.6 ± 18.2 ms; p < 0.05), and circumferential-basal STE-dyssynchrony (young: 50.2 ± 20.5 ms, middle: 75.9 ± 20.6 ms, older 97.9 ± 20.2 ms; p < 0.05).This study enabled comprehensive profiling of LV mechanics at different stages of aging using sensitive echocardiographic technology.These factors may be key underlying contributors to myocardial dysfunction during aging, and their recognition may promote an advanced understanding of early signs of cardiovascular disease.

View Article: PubMed Central - HTML - PubMed

Affiliation: School of Exercise Science, Australian Catholic University, Locked Bag 4115, Fitzroy, MDC Victoria 3065, Australia. edwardcrendal@gmail.com.

ABSTRACT

Background: Evaluation of sensitive myocardial mechanics with speckle tracking echocardiography (STE) across the lifespan may reveal early indicators of cardiovascular disease (CVD) risk. Epicardial adipose tissue (EAT) and left ventricular (LV) myocardial dyssynchrony; subclinical risk-factors of CVD, are of particular clinical interest. However, the evolution of EAT and LV-dyssynchrony across the lifespan, and their influence on myocardial dysfunction remains unclear. We aimed to establish a profile of the healthy aging-heart using conventional, tissue-Doppler imaging (TDI) and speckle-tracking echocardiography (STE), while also exploring underlying contributions from EAT and LV-dyssynchrony towards LV myocardial mechanics, independent of blood biology.

Methods: Healthy males aged 19-94 years were recruited through University-wide advertisements in Victoria and New-South Wales, Australia. Following strict exclusion criteria, basic clinical and comprehensive echocardiographic profiles (conventional, TDI and STE) were established. LV-dyssynchrony was calculated from the maximum-delay of time-to-peak velocity/strain in the four LV-annulus sites (TDI), and six LV-segments (STE longitudinal and circumferential axes). Epicardial fat diameter was obtained from two-dimensional grey-scale images in the parasternal long-axis. Blood biological measures included glycemia, hsCRP, triglycerides, total cholesterol, high-density and low-density lipoprotein levels.

Results: Three groups of 15 were assigned to young (<40 years), middle (40-65 years), and older (>65) aged categories. Five participants were excluded from STE analyses due to inadequate image quality. Decreased longitudinal strain, increased circumferential apical strain and LV twist were age-related. Moreover, independent of blood biology, significant increases were observed across age categories for EAT (young: 2.5 ± 0.9 mm, middle: 3.9 ± 1.0 mm, older 5.7 ± 2.4 mm; p < 0.01), longitudinal STE-dyssynchrony (young: 42 ± 7.7 ms, middle: 58.8 ± 18.9 ms, older 88.6 ± 18.2 ms; p < 0.05), and circumferential-basal STE-dyssynchrony (young: 50.2 ± 20.5 ms, middle: 75.9 ± 20.6 ms, older 97.9 ± 20.2 ms; p < 0.05). These variables collectively explained 37% and 31% (p < 0.01) of longitudinal strain and LV twist, respectively.

Conclusions: This study enabled comprehensive profiling of LV mechanics at different stages of aging using sensitive echocardiographic technology. Novel findings included increased epicardial fat, and both longitudinal and circumferential LV-dyssynchrony across the healthy age groups. These factors may be key underlying contributors to myocardial dysfunction during aging, and their recognition may promote an advanced understanding of early signs of cardiovascular disease.

Show MeSH
Related in: MedlinePlus