Key result
Aging is linked to ~3-fold higher LV systolic energy loss and shifted intraventricular dissipation.
Why the study?
Standardized adult reference values for vector flow mapping-derived left ventricular energy loss are not established, and the clinical significance of separate systolic and diastolic assessments has not been fully explored.
Does aging affect systolic and diastolic left ventricular energy loss assessed by vector flow mapping in healthy participants?
Observational (n=41)
No
Does aging affect systolic and diastolic left ventricular energy loss assessed by vector flow mapping in healthy participants?
Vector flow mapping reveals that aging is associated with a selective increase in systolic left ventricular energy loss, suggesting altered intraventricular flow efficiency despite preserved ejection fraction.
Answers are grounded in this paper and cite their sources.
May indicate reduced LV flow efficiency with aging; hypothesis-generating for VFM energy loss as subclinical marker, pending outcome validation.
Energy loss (EL) derived from vector flow mapping (VFM) is an indicator of intraventricular flow efficiency in the left ventricle. However, standardized reference values in adults have not been established. Furthermore, the clinical significance of systolic and diastolic EL assessments has not been fully explored. Therefore, we aimed to separately quantify VFM-derived EL during systole and diastole in healthy participants, and to clarify age-related differences. This single-center retrospective observational study included 41 healthy participants (young group < 65-years-old, n = 16; elderly group ≥ 65-years-old, n = 25) who underwent transthoracic echocardiography between April 2025 and April 2026. VFM was used to quantify maximum mean EL, mean systolic EL (Mean ELS), mean diastolic EL (Mean ELD), the diastolic-to-systolic EL ratio (ELD/ELS), and the ratio of the diastolic to systolic EL area under the time curve (AUCD/AUCS). In addition, EL indices normalized by stroke volume (SV), cardiac output (CO), mitral inflow velocities (E and A waves), and myocardial relaxation index (e′) were evaluated. Statistical analyses were conducted using the Shapiro–Wilk test, independent t-test, Mann–Whitney U test, and Fisher’s exact test. The maximum mean EL and Mean ELS were significantly higher in the elderly group than in the younger group, whereas no significant difference was observed in Mean ELD. In phase-based comparisons, the ELD/ELS and AUC ratios were significantly lower in the elderly group. Among the normalized EL parameters, Mean ELS/SV and Mean ELS/CO remained significantly higher in the elderly group, indicating that age-related differences in EL persisted after normalization. VFM-derived EL exhibits age-related, phase-dependent changes characterized by a selective increase in systolic EL and altered phase distribution in healthy participants. Separate assessment of systolic and diastolic EL may provide insights into left ventricular flow efficiency beyond conventional echocardiographic indices. jRCT1030250395 (Registration date: 29 September 2025).
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Otani et al. (2026) conducted an observational in Healthy participants (n=41). Aging (Elderly ≥ 65 years) vs. Younger group (< 65 years) was evaluated on Mean systolic energy loss (Mean ELS) in J/(m³·s) (p=<0.001). In healthy participants, aging was associated with a significant increase in mean systolic energy loss (/(m³·s)) and a shift in intraventricular energy dissipation toward systole.
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