Correlations Between Echo-Doppler Indexes and Exercise Testing in the Elderly

Introduction: The ageing heart is characterised by an abnormal diastolic filling curve due to prolonged re- laxation. The purpose of this study was to investigate a possible correlation between exercise capability and diastolic dysfunction of the left ventricle (LV) in elderly people by exercise testing (Ext) and Doppler echocardiography. Methods: We studied 20 persons ( mean age 74±4.02 years); free of hypertension, coronary artery disease, heart failure, chronic atrial fibrillation and LBBB. All subjects underwent an echo doppler study and exercise test using the standard Bruce protocol. The following doppler indexes were measured: 1. E and A maximum velocities, 2. E/A ratio, 3. Deceleration time (DT), 4. Isovolumic relaxation time (IVRT). We also recorded: a)exercise duration (Dex), b) maximum blood pressure (BPmax), c) maximum heart rate (HRmax). Possible correlations between echo doppler and Ext indexes we determined using Pear- son's test. Results: All subjects had a negative exercise test and a transmitral flow pattern of prolonged relaxation type. We noticed a negative correlation between DT and a) Dex (r: -0.652 p: 0.041), b) BPmax (r: -0.912 p: 0.000) and c) HRmax (r: -0.743 p: 0.014). No other correlation had been found between exercise test and doppler indexes. DT was the only independent variable contributing to stress test duration that was re- tained in a multivariate analysis (F: 5.905 p: 0.041, ‚: -0.271, constant: 11.824), (the variables analyzed were: age, echocardiographic indexes of diastolic function and clinical indexes at rest). Conclusions: It seems that the functional ability of the elderly can be estimated by the deceleration time (DT), (as the DT increases the maximum Dex and the maximum inotropic and chronotropic response de- creases). The independent correlation of DT with stress test duration was confirmed by multivariate analysis.