Left ventricular remodeling with age in normal men versus women: Novel insights using three-dimensional magnetic resonance imaging

Echocardiogrophic left ventricular (IV) wall thickness increases with age, suggesting IV hypertrophy. However, autopsy studies have shown no change, or even a decrease, in IV mass with age. With many pathologies, IV remodeling results in changes in ventricular shape. Age-associated IV shape change might explain this discrepancy, although this has not been studied. Magnetic resonance imaging (MRI) was used in 336 healthy, normotensive adults (mean age 56 +/- 18 years; 200 women, 136 men) to measure IV mass, end-diastolic IV wall thickness, length, diameter, and shape. Echocardiographic IV mass was measured in a subset of 86 subjects by a standard algorithm. In women, IV wall thickness increased by 14% (r = 0.19, p <0.02), whereas IV length decreased by 9% (r = -0.26, p = 0.0006); IV diameter was unchanged. Thus, IV mass did not vary with age (r -0.04, p = 0.06) and the sphericity index decreased (r = -0.165, p <0.05). In men, IV wall thickness and diameter were unrelated to age, but there was an 11% decrease in IV length (r = -0.29, p 0.003); therefore, there was an 11% decrease in IV mass (r = -0.20, p = 0.019) and a decrease in the sphericity index (r = -0.218, p <0.04). No change occurred in echocardiographic IV mass with age in either gender, although echocardiographic IV wall thickness increased in both. The left ventricle becomes more spherical with age in normal adults due to reduced IV lengths In women, increased IV wall thickness offsets the decreasing IV length, whereas in men, IV wall thickness' fails to compensate, resulting in decreased IV mass with age. (C) 2002 by Excerpta Medica, Inc.