Age related structural and functional changes in left ventricular performance in healthy subjects: a 2D echocardiographic study

  • Olga VrizEmail author
  • Mario Pirisi
  • Eiad Habib
  • Domenico Galzerano
  • Bahaa Fadel
  • Francesco Antonini-Canterin
  • Gruschen Veldtman
  • Eduardo Bossone
Original Paper


Left ventricular (LV) adaptation to aging is currently poorly understood. We aimed to characterize age related changes in LV structure and function by studying a large group of healthy subjects across a wide age range. Prospectively enrolled healthy volunteers (n = 778, 327 females; age 18 to 100 years, mean age 49.8 ± 18.1 years), were divided into 4 age groups: 18 to 34 years (n = 165); 35 to 49 years (n = 242), 50 to 79 years (n = 334) and ≥ 80 years (n = 40). All subjects underwent clinical examination, as well as comprehensive transthoracic echocardiogram [TTE]. Body mass index, systolic blood pressure (BP), and left atrial volume (p < 0.0001) increased with age while diastolic BP (p < 0.0001) decreased over time. LV mass/body surface area (BSA) and relative wall thickness increased with age (p < 0.0001) coincident with worsening parameters of diastolic function (E/A and E/Em, p < 0.0001). The ejection fraction and Sm did not change significantly. Stroke volume, ejection time index, flow rate and stroke work significantly increased with age (p < 0.01). The arterial elastance (Ea), a measure of ventricular afterload, and ventricular elastance (Ees), an index of LV systolic stiffness did not change with age nor did their ratio (Ees/Ea) the latter being an expression of ventricular-arterial coupling. Age, gender and LVM were the main independent variables associated with LV systolic function. In conclusion, LV adaptation to aging in a healthy cohort is characterized by concentric LV remodeling, increased contractility and preserved ventricular-arterial coupling.


Left ventricular function Aging Echocardiography 



This study was partially fund by the AGING PROJECT—Department of Excellence—Università del Piemonte Orientale, Novara, Italy

Compliance with ethical standards

Conflict of interest

None of the authors had any personal or financial conflict of interest. All authors take responsibility for all aspects of the reliability and freedom from bias of the data presented and their discussed interpretation.

Ethical approval

All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards.

Informed consent

Informed consent was obtained from all individual participants included in the study.


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Copyright information

© Springer Nature B.V. 2019

Authors and Affiliations

  1. 1.Heart Centre DepartmentKing Faisal Specialist Hospital & Research CenterRiyadhKingdom of Saudi Arabia
  2. 2.Cardiology and Emergency San Antonio HospitalSan Daniele del FriuliItaly
  3. 3.Department of Translational MedicineUniversità del Piemonte OrientaleNovaraItaly
  4. 4.Alfaisal UniversityRiyadhKingdom of Saudi Arabia
  5. 5.Ospedale Riabilitativo di Alta Specializzazione di Motta di LivenzaTrevisoItaly
  6. 6.U.O.C Riabilitazione Cardiovascolare, A CardarelliNaplesItaly

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