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June 2, 1996European Heart Journal118 citations

Age-related transmural peak mean velocities and peak velocity gradients by Doppler myocardial imaging in normal subjects

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PPPrzemysław PalkaSt Andrew’s HospitalALAleksandra LangeSt Andrew’s HospitalAFAlan FlemingEdinburgh Cancer Research

Key Result

Increasing age correlated with decreased peak velocity gradient during rapid ventricular filling (r=0.83; P<0.0001) and increased gradient during atrial contraction (r=0.86; P<0.0001).

Key Points

  • To establish the normal range and evaluate age-related variations of transmural peak mean velocities and velocity gradients across the left ventricular posterior wall in healthy individuals.
  • Prospective study of N=42 healthy subjects ranging in age from 21 to 78 years (mean 47 ± 16 years).
  • M-mode Doppler myocardial imaging was performed to measure peak mean velocity and peak velocity gradient across the left ventricular posterior wall during standardized cardiac cycle phases.
  • Linear regression analysis was used to assess correlations between subject age and measured myocardial velocity parameters.
  • Peak velocity gradient decreased with increasing age during rapid ventricular filling (r = 0.83, P < 0.0001) and increased during atrial contraction (r = 0.86, P < 0.0001).
  • Peak mean velocity increased significantly with age exclusively during atrial contraction (r = 0.80, P < 0.0001).
  • Systolic peak mean velocities and velocity gradients showed no significant correlation with increasing age across the cardiac cycle.

Study Design

Type

Observational (n=42)

Structured PICO

P
Population
42 normal subjects (age from 21 to 78, mean 47 +/- 16 years)
I
Intervention
M-mode Doppler myocardial imaging
O
Outcome
Peak values of the mean velocity and velocity gradient across the left ventricular posterior wall during standardized phases of the cardiac cyclesurrogate

Doppler myocardial imaging establishes age-related normal ranges for transmural myocardial velocities, showing significant changes in diastolic filling phases with age.

Main Result

p-value: p=<0.0001

Abstract

Doppler myocardial imaging is a new cardiac ultrasound technique based on the principles of colour Doppler imaging which can determine myocardial velocities by detecting the changes of phase-shift of the ultrasound signal returning directly from the myocardium. To determine the normal range of transmural velocities in healthy hearts a prospective study was carried out involving 42 normal subjects (age from 21 to 78, mean 47 +/- 16 years). Using M-mode Doppler myocardial imaging the peak values of the mean velocity and velocity gradient across the left ventricular posterior wall were measured during standardized phases of the cardiac cycle. Peak mean velocities had the following values during the cardiac cycle: isovolumic contraction - 1.3 +/- 1.2 cm. s-1, early ventricular ejection 4.2 +/- 1.2 cm. s-1, late ventricular ejection 1.8 +/- 1.1 cm. s-1, isovolumic relaxation -2.0 +/- 0.8 cm. s-1, rapid ventricular filling -6.6 +/- 2.2 cm. s-1, atrial contraction -2.8 +/- 1.8 cm. s-1, atrial relaxation 1.2 +/- 1.1 cm. s-1. Peak velocity gradients were: isovolumic contraction 1.3 +/- 1.9 s-1, early ventricular contraction 4.7 +/- 1.9 s-1, late ventricular contraction 1.1 +/- 1.0 s-1, isovolumic relaxation -0.6 +/- 0.5 s-1, rapid ventricular filling 6.1 +/- 3.4 s-1, atrial contraction 2.6 +/- 1.7 s-1, atrial relaxation 0.0 +/- 0.3 s-1. Linear regression analysis showed that with the increase of age, peak velocity gradient decreases during rapid ventricular filling (r = 0.83; P < 0.0001) and increases during atrial contraction (r = 0.86; P < 0.0001) while peak mean velocity increases only during atrial contraction (r = 0.80, P < 0.0001). Thus, there was no correlation between increasing age and systolic peak mean velocity and peak velocity gradient but both diastolic filling phases rapid ventricular filling and atrial contraction demonstrated age-related changes. In summary, this study has determined the age-related range of normal transmural myocardial velocities within the left ventricular posterior wall in healthy hearts during the cardiac cycle. We conclude that these measurements of peak mean velocities and peak velocity gradients, should form the baseline for subsequent Doppler myocardial imaging clinical studies on myocardial diseases processes.

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Cite This Study

Palka et al. (1996) conducted an observational in Healthy subjects (n=42). Doppler myocardial imaging was evaluated on Peak mean velocities and peak velocity gradients across the left ventricular posterior wall (p=<0.0001). Increasing age correlated with decreased peak velocity gradient during rapid ventricular filling (r=0.83; P<0.0001) and increased gradient during atrial contraction (r=0.86; P<0.0001).

synapsesocial.com/papers/6a0d5531cae7912d2fa4ea6ehttps://doi.org/10.1093/oxfordjournals.eurheartj.a014977
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