The Normal Impact of Age and Gender on Right Heart Structure and Function

Authors

  • Michael Henein M.D.,

    1. Department of Cardiology, Umeå University, Umeå, Sweden
    2. Department of Public Health and Clinical Medicine, Umeå University, Umeå, Sweden
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  • Anders Waldenström M.D.,

    1. Department of Public Health and Clinical Medicine, Umeå University, Umeå, Sweden
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  • Stellan Mörner M.D.,

    1. Department of Cardiology, Umeå University, Umeå, Sweden
    2. Department of Public Health and Clinical Medicine, Umeå University, Umeå, Sweden
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  • Per Lindqvist Ph.D.

    Corresponding author
    1. Department of Clinical Physiology, Umeå University, Umeå, Sweden
    2. Department of Surgical and Perioperative Sciences, Heart Center, Umeå University, Umeå, Sweden
    • Address for correspondence and reprint requests: Per Lindqvist, Ph.D., Department of Public Health and Clinical Medicine, Umea University Hospital, Umea S-901 85, Sweden.

      Fax: +4690137633;

      E-mail: per.lindqvist@medicin.umu.se

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Abstract

Background

As the proportion of elderly population increases rapidly, it might be difficult to differentiate physiological changes in cardiac function due to age from the pathophysiological ones. In addition, cardiac function variations with gender are well established. The right ventricular (RV) plays an important role in the overall cardiac function, but reference values varying with age and gender are lacking.

Material and Methods

We studied 255 healthy individuals from a general population register, mean age of 58 ± 19 (range 22–89) years, 125 were females. We used 2D and M-mode echocardiography to measure RV inflow tract (RVIT) and RV outflow tract (RVOT) dimensions and fractional shortening (fs). Spectral Doppler echocardiography was also used.

Results

We found a modest decrease in RVIT dimensions (P < 0.05), but increase in RVOT dimensions with advancing age (P < 0.05). A small decrease in RVOT fs with age was also found (P < 0.05). Estimated pulmonary pressures and pulmonary vascular resistance increased (P < 0.001) as did RVOT wall thickness (P < 0.001), but RV diastolic function was not altered (P < 0.001) with age. Despite correction for the BSA, males showed larger RVIT dimensions (P < 0.001 for both), but RVOT end-diastolic dimension was larger in females (P < 0.05). RVIT and RVOT fractional shortening were increased in females (P < 0.01 for both).

Conclusion

In a cohort of normal individuals, age has significant impact on RV structure and function, inlet area falls and outflow tract dimensions increase and fractional shortening also increase in females. In addition, RVOT wall thickness significantly increases and Doppler markers of pulmonary vascular resistance show a consistent rise. The age-related changes should carefully be considered when commenting on normality and when using absolute values.

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