Tissue Doppler imaging of the left ventricle in healthy elderly females does not support the concept of “isolated” diastolic dysfunction

The concept of "isolated" left ventricular diastolic dysfunction has recently been challenged, since left ventricular contraction abnormalities can be demonstrated in subjects with normal left ventricular ejection fraction (EF). In this study of 35 healthy females (aged 65--80 years) with EF>50%, the ratio of peak early transmitral flow velocity to peak early diastolic myocardial velocity (E/Em) correlated significantly with peak systolic myocardial longitudinal velocity (Sm) (r=-0.57, p<0.0001), assessed as an average in six basal left ventricular segments. E/Em correlated also with age (r=0.51, p<0.002), but not significantly with ambulatory daytime systolic blood pressure (r=0.32, p=0.06), nor with left ventricular mass. In conclusion, there is a significant correlation between left ventricular diastolic and systolic function also in an apparently healthy population when adequately sensitive methods are used, in terms of tissue Doppler assessment of the left ventricular longitudinal motion. Although age may influence left ventricular longitudinal motion, an influence of arterial blood pressures is unclear.