Racial Differences in Age-Related Changes in Left Ventricular Structural and Functional Echocardiographic Measurements Among Healthy Japanese and American Participants　― A Subanalysis of the World Alliance Society of Echocardiography Normal Values Study

• Published in: Circulation Journal Vol. 88; no. 9; pp. 1461 - 1471
• Main Authors: Nakao, Tomoko, Nakanishi, Koki, Sawada, Naoko, Kawahara, Takuya, Miyoshi, Tatuya, Takeuchi, Masaaki, Asch, Federico M., Lang, Roberto M., Daimon, Masao
• Format: Journal Article
• Language: English
• Published: Japan The Japanese Circulation Society 23.08.2024
• Subjects: Adult; Age Factors; Aged; Aged, 80 and over; Aging; Aging - ethnology; Aging - physiology; Asian People; Black or African American; Body Mass Index; Cross-Sectional Studies; East Asian People; Echocardiography; Female; Heart Ventricles - diagnostic imaging; Heart Ventricles - physiopathology; Humans; Japan; Left ventricular mass; Left ventricular size; Left ventricular systolic function; Male; Middle Aged; Race; Reference Values; Stroke Volume; United States; Ventricular Function, Left; White People; United States; Japan; Aging; Left ventricular mass; Left ventricular systolic function; Left ventricular size; Race
• ISSN: 1346-9843; 1347-4820; 1347-4820
• DOI: 10.1253/circj.CJ-24-0031

Background: Age-related changes in left ventricular (LV) structure and function lower the threshold for the onset of heart failure with preserved ejection fraction (HFpEF). LV parameters change also with race; however, the racial differences in age-related changes in LV parameters with and without adjustment for body mass index (BMI), heart rate (HR), and blood pressure (BP) remain unclear.Methods and Results: We performed a subanalysis of the World Alliance Society of Echocardiography Normal Values Study, an international cross-sectional study that examined normal echocardiographic values in 15 countries. The age-related changes in 2-dimensional echocardiographic derived parameters including LV size, systolic function, and mass, were compared between healthy Japanese (n=227) and healthy White (n=98) and Black (n=69) American participants. In men, age-related changes in all parameters did not differ significantly among races. However, compared with Japanese women, White American women had a smaller body surface area (BSA)-indexed LV volume, BSA-indexed LV internal dimension at end-systole, BSA-indexed LV stroke volume, and LV mass index to BSA, and a larger LV ejection fraction with age, even after adjusting for BMI, HR, and BP.Conclusions: Age-related changes in LV structure and function, which are important for the pathophysiology of HFpEF, may differ by race. Therefore, future studies examining echocardiographic reference values for each age group in each race are needed.