Ageing induces left ventricular concentric remodelling in normotensive subjects

Objective: To assess whether age affects left ventricular anatomy independently of age-related hypertension or concomitant heart diseases. Design and methods: In 430 consecutive normotensive and clinically healthy subjects aged 16-85 years we obtained echocardiographic measurements of left ventricular posterior wall thickness, internal diameter, relative wall thickness, Penn mass index and systemic haemodynamics. The pulse pressure:stroke volume ratio was calculated as an estimate of systemic arterial stiffness. The subjects were divided into three age groups: less than or equal to 40 (group 1, n=137), 41-64 (group 2, n=261) and 265 years (group 3, n=32). Results: Systolic blood pressure increased from group 1 to group 3, as did the pulse pressure:stroke volume ratio and posterior wall thickness, whereas the left ventricular internal diameter was less in group 3 than in groups 1 and 2. The relative wall thickness increased from group 1 to groups 2 and 3, whereas the left ventricular mass index did not differ among age groups. Age was related positively to the systolic blood pressure, pulse pressure:stroke volume ratio, posterior wall thickness index and relative wall thickness, and negatively to the left ventricular internal diameter but not to the left ventricular mass index. Conclusions: In healthy adults, relative wall thickness increases with age whereas left ventricular mass does not change. The concentric remodelling of left ventricular geometry parallels age-related stiffening of the arterial tree, elevation of systolic blood pressure and decrease in left ventricular volume. Thus partition values of relative wall thickness should be adjusted for age.