Association of newer diastolic function parameters with age in healthy subjects: A population-based study

Objectives. We sought to determine if newer Doppler diastolic function parameters are associated with age and to define age-stratified reference ranges for these parameters in a population-based setting. Background: Although newer Doppler parameters aid in the evaluation of diastolic function and filling pressures, age-specific reference ranges are poorly described. Methods: Randomly selected residents of Olmsted County, Minn, age greater than or equal to 45 years were studied (n = 2042) prospectively. Those without a history of cardiovascular disease or abnormal 2-dimensional echocardiograms were selected. Measured parameters included the transmitral early (E) and late (A) filling velocities at rest and with Valsalva, A duration, pulmonary venous atrial reversal duration, lateral and septal early diastolic mitral annular velocities, E/lateral early diastolic mitral annular velocity, E/septal early diastolic mitral annular velocity, and the index of left ventricular myocardial performance. Results: A total of 1012 subjects met the inclusion criteria. Both A duration (r = 0.18, P < .001) and pulmonary venous atrial reversal duration (r = 0.28, P < .001) were longer in older subjects, whereas their difference showed a marginal correlation with age (r = 0.07, P = .036). The E/A ratio at peak Valsalva correlated with age (r = -0.54, P < .001) whereas the change in E/A with Valsalva (corrected for E-A fusion) showed a marginal correlation with age (r = 0.08, P = .032). Both E/lateral early diastolic mitral annular velocity (r = 0.39, P < .001) and E/septal early diastolic mitral annular velocity (r = 0.27, P < .001) increased with age. Left ventricular myocardial performance showed a marginal correlation with age (r = 0.08, P = .014). Age specific reference ranges (median, 5th and 95th percentiles) for all parameters are provided. Conclusions: All newer Doppler diastolic function parameters showed a variable but significant correlation with age. Age-specific reference values will aid in the interpretation of diastolic function parameters.