Echocardiographically estimated left ventricular end-diastolic and right ventricular systolic pressure in normotensive healthy individuals.

AIM: To study the effect of aging on and the relationship between echocardiographically estimated left ventricular (LV) filling pressure and estimated right ventricular (RV) systolic pressure among healthy normotensive individuals.
METHODS: We analyzed 249 healthy individuals (aged 18-82 years, 52% men) with normal echocardiographic findings and reliably measurable tricuspid regurgitation gradients. Subjects with blood pressure >140/90 mmHg and/or LV hypertrophy were excluded. LV & RV dimensions and LV mass were measured with M-mode echocardiography. Atrial (A) volumes were determined with the area-length method. Diastolic function was assessed with transmitral Doppler and mitral annulus tissue Doppler. The ratio of transmitral early peak velocity to early diastolic mitral annulus velocity (E/E') was used as estimation of LV filling pressure. The transtricuspid Doppler gradient was used to estimate RV end-systolic pressure.
RESULTS: Even in normotensive individuals aging was accompanied by an increase in LV mass and LA dimensions and an increase in relaxation abnormalities. E/E' increased with every decade: from 7.8 for age 18-35 years to 10.9 for age > or =75 years (p<0.0001) as did the transtricuspid gradient: from 18.3 mmHg for age 18-35 years to 25.8 mmHg for age > or =75 years (p<0.0001). Linear regression showed that estimated RV systolic pressure was independently predicted by age, LA volume, LV systolic function and E/E'.
CONCLUSION: Among normotensive healthy individuals both E/E' and tricuspid regurgitation gradients increase significantly with aging. Moreover the E/E' ratio was independently predicting the tricuspid regurgitation gradient. These findings support the need for further studies defining age specific normal values.