Left ventricular filling patterns and pulmonary artery pressures in patients aged 90 to 100 years with normal echocardiography results

Left ventricular filling and pulmonary artery pressure (PAP) have not been well described in patients greater than or equal to 90 years old. We reviewed our database to obtain echocardiograms with normal findings in this age group. The peak early and late mitral filling velocities, the early and late velocity-time integral (VTI), the mitral deceleration time, and the atrial filling fraction (late VII/total VII) were measured. PAP was obtained from the peak tricuspid regurgitation velocity. Of 252 echocardiograms performed on patients greater than or equal to 90 years old, 47 (19%) were normal. The mean +/- SD values were: ratio of peak early and late mitral filling velocities, 0.69 +/- 0.16; deceleration time, 240 milliseconds 31; ratio of early and late VTI, 1.0 +/- 0.3; atrial filling fraction, 47% +/- 7; and PAP, 31 mm Hg +/- 6. Left ventricular filling in patients aged 90 to 100 years demonstrates increasingly impaired left ventricular relaxation from patients in their eighth and ninth decades. PAP continues to increase with age and PAP less than or equal to 40 mm Hg in the elderly could be considered normal. (J Am Soc Echocardiogr 2003;16:664-9.).