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European Journal of Heart Failure 2005 7(5):829-833; doi:10.1016/j.ejheart.2004.09.008
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© 2004 European Society of Cardiology

Echocardiographic evaluation of left ventricular end-systolic elastance in the elderly

Domenico de Santisa, Pasquale Abetea,*, Gianluca Testaa, Francesco Cacciatoreb, Gianluigi Galiziaa, Dario Leoscoa, Luisa Viatia, Vincenzo Del Villanoa, David Della Mortea, Francesca Mazzellaa, Nicola Ferrarab and Franco Rengoa,b

a Cattedra di Geriatria-Dipartimento di Medicina Clinica, Scienze Cardiovascolari ed Immunologiche Universitá degli Studi di Napoli "Federico II", Via S. Pansini, 5, 80131 Naples, Italy
b Istituto scientifico di Telese Terme Fondazione Salvatore Maugeri, IRCCS, Benevento, Italy

* Corresponding author. Tel.: +39 081 746 2270; fax: +39 081 746 2339. E-mail address: p.abete{at}unina.it


  Abstract

Background: The aging heart is characterized by structural changes, which are implicated in the development of left ventricular diastolic dysfunction. However, important changes in systolic function may also occur. Left ventricular end-systolic elastance (Ees) is a major determinant of cardiac systolic function and ventricular—arterial interaction.

Aim: To evaluate left-ventricular Ees in elderly subjects compared with adult control subjects.

Methods: We studied dilated (DA, n=14) and hypertensive (HA, n=21) cardiomyopathy patients, and both adult control (A, n=25; age 55.6±6.6 years) and elderly (E, n=25; age 76.3±7.1 years) subjects without clinical–instrumental evidence of cardiovascular disease. M-mode, two-dimensional, and pulsed Doppler echocardiogram were performed. Doppler-derived indices of diastolic function were assessed and Ees was calculated by a modified single-beat method.

Results: Ees was reduced in dilated cardiomyopathy (1.32±0.10 mm Hg/ml) and increased in hypertensive cardiomyopathy (3.12±0.33 mm Hg/ml) patients compared to age-matched control subjects (1.96±0.26 mm Hg/ml; p<0.01 and p<0.05, respectively). More importantly, Ees was higher in the elderly (2.52±0.70 mm Hg/ml) than in the adult control group (p<0.05) and was linearly correlated with age (r2=0.639; p<0.0001).

Conclusion: Age-related increase in Ees, together with diastolic dysfunction, may lead to aging heart decompensation.

Key Words: Elastance • Elderly • Echocardiography • Diastole

Received February 6, 2004; Revised September 10, 2004; Accepted September 20, 2004


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