Increased myocardial dysfunction, dyssynchrony, and epicardial fat across the lifespan in healthy males

BMC Cardiovascular Disorders

Research Article

Tracey McDonald¹  Geraldine Naughton¹  Fred Dutheil²  Edward Crendal³  Philippe Obert³ 

[1] School of Exercise Science, Australian Catholic University, Locked Bag 4115, 3065, Fitzroy, MDC Victoria, Australia;School of Exercise Science, Australian Catholic University, Locked Bag 4115, 3065, Fitzroy, MDC Victoria, Australia;Laboratory of Metabolic Adaptations to Exercise in Physiological and Pathological conditions EA3533, Blaise Pascal University, Clermont-Ferrand, France;Occupational Medicine, University Hospital CHU G. Montpied, Clermont-Ferrand, France;School of Exercise Science, Australian Catholic University, Locked Bag 4115, 3065, Fitzroy, MDC Victoria, Australia;Laboratory of Pharm-Ecology Cardiovascular EA4278, School of Sport Sciences and Exercise, University of Avignon, Avignon, France;

关键词: Aging;    Speckle tracking echocardiography;    Dyssynchrony;    Myocardial dysfunction;    Epicardial fat;   

DOI  :  10.1186/1471-2261-14-95

 received in 2014-05-27, accepted in 2014-07-23,  发布年份 2014

来源: Springer

【 摘 要 】

BackgroundEvaluation of sensitive myocardial mechanics with speckle tracking echocardiography (STE) across the lifespan may reveal early indicators of cardiovascular disease (CVD) risk. Epicardial adipose tissue (EAT) and left ventricular (LV) myocardial dyssynchrony; subclinical risk-factors of CVD, are of particular clinical interest. However, the evolution of EAT and LV-dyssynchrony across the lifespan, and their influence on myocardial dysfunction remains unclear. We aimed to establish a profile of the healthy aging-heart using conventional, tissue-Doppler imaging (TDI) and speckle-tracking echocardiography (STE), while also exploring underlying contributions from EAT and LV-dyssynchrony towards LV myocardial mechanics, independent of blood biology.MethodsHealthy males aged 19–94 years were recruited through University-wide advertisements in Victoria and New-South Wales, Australia. Following strict exclusion criteria, basic clinical and comprehensive echocardiographic profiles (conventional, TDI and STE) were established. LV-dyssynchrony was calculated from the maximum-delay of time-to-peak velocity/strain in the four LV-annulus sites (TDI), and six LV-segments (STE longitudinal and circumferential axes). Epicardial fat diameter was obtained from two-dimensional grey-scale images in the parasternal long-axis. Blood biological measures included glycemia, hsCRP, triglycerides, total cholesterol, high-density and low-density lipoprotein levels.ResultsThree groups of 15 were assigned to young (<40 years), middle (40–65 years), and older (>65) aged categories. Five participants were excluded from STE analyses due to inadequate image quality. Decreased longitudinal strain, increased circumferential apical strain and LV twist were age-related. Moreover, independent of blood biology, significant increases were observed across age categories for EAT (young: 2.5 ± 0.9 mm, middle: 3.9 ± 1.0 mm, older 5.7 ± 2.4 mm; p < 0.01), longitudinal STE-dyssynchrony (young: 42 ± 7.7 ms, middle: 58.8 ± 18.9 ms, older 88.6 ± 18.2 ms; p < 0.05), and circumferential-basal STE-dyssynchrony (young: 50.2 ± 20.5 ms, middle: 75.9 ± 20.6 ms, older 97.9 ± 20.2 ms; p < 0.05). These variables collectively explained 37% and 31% (p < 0.01) of longitudinal strain and LV twist, respectively.ConclusionsThis study enabled comprehensive profiling of LV mechanics at different stages of aging using sensitive echocardiographic technology. Novel findings included increased epicardial fat, and both longitudinal and circumferential LV-dyssynchrony across the healthy age groups. These factors may be key underlying contributors to myocardial dysfunction during aging, and their recognition may promote an advanced understanding of early signs of cardiovascular disease.

【 授权许可】

CC BY   
© Crendal et al.; licensee BioMed Central Ltd. 2014