Age- and Sex-Related Influences on Left Ventricular Mechanics in Elderly Individuals Free of Prevalent Heart Failure: The ARIC Study (Atherosclerosis Risk in Communities).
BACKGROUND
Advanced age is related to left ventricular (LV) remodeling. We sought to investigate the relationships between aging, elevated hemodynamic load, cardiac mechanics, and LV remodeling in an elderly community-based population.


METHODS AND RESULTS
We studied 1105 subjects (76±5 years, 61% women) without prevalent heart failure, who attended the visit 5 of the ARIC study (Atherosclerosis Risk in Communities). LV global longitudinal strain, global circumferential strain, and torsion indices were analyzed using 3-dimensional echocardiography. Advanced age was associated with greater LV concentricity, lower myocardial diastolic relaxation, reduced global longitudinal strain (adjusted estimate, 0.39±0.19% (SE)/decade; P=0.038), borderline greater global circumferential strain (adjusted estimate, -0.59±0.36% (SE)/decade; P=0.08), and higher torsion indices (adjusted estimate for torsion, 0.33±0.04° (SE)/decade; P<0.001). In addition, greater concentricity was associated with decreased global longitudinal strain and greater torsion in multivariable models (all P<0.001). Women showed smaller LV cavity size, greater concentricity, lower myocardial relaxation velocity E', though demonstrated greater global longitudinal strain, global circumferential strain, and torsion than men (all P<0.05). Overall, subjects with hypertension and increasing age were more likely to have higher torsion, though the association between advanced age and greater torsion was more pronounced in women than in men (both interaction P<0.05).


CONCLUSIONS
In an asymptomatic, senescent community-dwelling population, we observed a distinct, sex-specific pattern of cardiac remodeling. Although we observed worse diastolic and longitudinal function with advanced age or elevated load in both sexes, a significant increase of torsion was more pronounced in women.
['Hung|Chung-Lieh|CL|', 'Gonçalves|Alexandra|A|', 'Shah|Amil M|AM|', 'Cheng|Susan|S|', 'Kitzman|Dalane|D|', 'Solomon|Scott D|SD|']
D000367:Age Factors D000368:Aged D000369:Aged, 80 and over D050197:Atherosclerosis D001696:Biomechanical Phenomena D003430:Cross-Sectional Studies D003971:Diastole D019560:Echocardiography, Three-Dimensional D005260:Female D006333:Heart Failure D006439:Hemodynamics D006801:Humans D006973:Hypertension D008297:Male D015995:Prevalence D011446:Prospective Studies D012307:Risk Factors D012737:Sex Factors D013997:Time Factors D054159:Torsion, Mechanical D014481:United States D018487:Ventricular Dysfunction, Left D016277:Ventricular Function, Left D020257:Ventricular Remodeling
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