Left Ventricular Diastolic Function and Exercise Capacity in Community-Dwelling Adults ≥65 Years of Age Without Heart Failure - 15/08/11

Résumé |
Left ventricular diastolic dysfunction (LVDD) has been reported to have strong correlation with exercise capacity. However, this relationship has not been studied extensively in community-dwelling older adults. Data on pulse and tissue Doppler echocardiographic estimates of resting early (E) and atrial (A) transmitral peak inflow and early (Em) mitral annular velocities, and six-minute walk test were obtained from 89 community-dwelling older adults (mean age, 74; range, 65-93 years; 54% women), without a history of heart failure. Overall, 47% had cardiovascular morbidity and 60% had normal diastolic function (E/A 0.75-1.5 and E:Em <10). Among the 36 individuals with LVDD, 83%, 14% and 3% had grade I (E/A <0.75, regardless of E/Em), II (E/A 0.75-1.5 and E/Em ≥10) and III (E/A>1.5 and E/Em ≥10) LVDD, respectively. Those with LVDD were older (77 versus 73 years; p = 0.001) and had a trend for higher prevalence of cardiovascular morbidity (58% versus 40%; p = 0.083). LVDD negatively correlated with six-minute walk distance (1013 versus 1128 feet; R = −0.25; p = 0.017). This association remained significant despite adjustment for cardiovascular morbidity (R = −0.35; p = 0.048), but lost significance when adjusted for age (R = −0.32; p = 0.105), age and cardiovascular morbidity (R = −0.38; p = 0.161), and additional adjustment for sex, race, body mass index, and systolic blood pressure (R = −0.44; p = 0.365). In conclusion, most community-dwelling older adults without heart failure had normal left ventricular diastolic function or grade-I LVDD. Although LVDD was associated with decreased performance on a six-minute walk test, that association was no longer evident after adjustment for age, body mass index and cardiovascular morbidity.
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| Dr. Ahmed is supported by Grants R01-HL085561 and R01-HL097047 from the National Heart, Lung, and Blood Institute/National Institutes of Health, Bethesda, Maryland and a generous gift from Ms. Jean B. Morris, Birmingham, Alabama. |
Vol 108 - N° 5
P. 735-740 - septembre 2011 Retour au numéroBienvenue sur EM-consulte, la référence des professionnels de santé.
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