Background People over the age of 85 are a rapidly growing age group with a high incidence of congestive heart failure(CHF),in particular heart failure with preserved ejection fraction(HFp EF).The diagnosis of CHF is ...Background People over the age of 85 are a rapidly growing age group with a high incidence of congestive heart failure(CHF),in particular heart failure with preserved ejection fraction(HFp EF).The diagnosis of CHF is challenging and longitudinal data assessing cardiac structure and function are necessary to distinguish physiologic from pathologic cardiac aging.The objective of the study was to determine longitudinal changes in cardiac struture and function from ages 85 to 94 years using home echocardiography.Methods Subjects were recruited from the Jerusalem Longitudinal Cohort Study.Sixty three members of the initial cohort(32 F,31 M)who underwent home echocardiography at age 85 were the subjects of the current study and underwent repeat home 2-D and Doppler echocardiographic assessment at age 94.Results There were no significant longitudinal changes in left ventricular mass index(LVMI),however LV end-diastolic volume significantly decreased from 113.4±30 to 103.6±35.5 m L(P<0.02).Ejection fraction(EF)remained stable,however longitudinal systolic function significantly decreased with age from 7.9±1.8 to 6.6±1.4 cm/s2(P<0.0001).Diastolic function as assessed by increased E:e’(11.2±3.4 to 16±7.5,P<0.0001)and increased left atrial volume index(34.1±11.3 to 42.4±13.7 m L/m^2,P<0.0001)was reduced with aging.Conclusions This study demonstrated preserved EF with decreased longitudinal systolic function and diastolic function without significant change in LV mass.Changes in LV function in the very elderly may be independent of changes in LV geometry.展开更多
BACKGROUND Chronic mitral regurgitation(MR)is a volume overload state that causes dilatation of the left sided cardiac chambers.The presence of significant dilatation is considered an indication for mitral valve inter...BACKGROUND Chronic mitral regurgitation(MR)is a volume overload state that causes dilatation of the left sided cardiac chambers.The presence of significant dilatation is considered an indication for mitral valve intervention,however,aging may affect left ventricular(LV)remodeling independently of valvular disease.The objective of this study was to examine age-related changes in cardiac remodeling in a broad population of patients with chronic MR.METHODS Consecutive subjects that underwent echocardiography examinations recorded in the echocardiography database of a university-affiliated laboratory were retrieved.Subjects were categorized into none/mild,moderate or severe MR.For purposes of analysis of differences with aging,the population was divided into groups above and below 70 years of age and standard echocardiographic measurements were compared between the groups.RESULTS A total of 3492 subjects with at least moderate MR(mean age:76 years,52%female)were included in the study and compared to 18,250 subjects with none or mild MR.Older patients had significantly smaller LV end-diastolic diameters and volumes and significantly larger left atrial(LA)volumes when compared to the younger group.LA volume index increased in both age groups as MR severity increased,while LV end-diastolic volume increased with increasing MR only in the younger population.CONCLUSIONS Cardiac remodeling in chronic MR is significantly influenced by age.Guideline based recommendations of timing of mitral valve interventions in asymptomatic MR patients,based on assessment of LA and LV remodeling,may need to take age into account.展开更多
文摘Background People over the age of 85 are a rapidly growing age group with a high incidence of congestive heart failure(CHF),in particular heart failure with preserved ejection fraction(HFp EF).The diagnosis of CHF is challenging and longitudinal data assessing cardiac structure and function are necessary to distinguish physiologic from pathologic cardiac aging.The objective of the study was to determine longitudinal changes in cardiac struture and function from ages 85 to 94 years using home echocardiography.Methods Subjects were recruited from the Jerusalem Longitudinal Cohort Study.Sixty three members of the initial cohort(32 F,31 M)who underwent home echocardiography at age 85 were the subjects of the current study and underwent repeat home 2-D and Doppler echocardiographic assessment at age 94.Results There were no significant longitudinal changes in left ventricular mass index(LVMI),however LV end-diastolic volume significantly decreased from 113.4±30 to 103.6±35.5 m L(P<0.02).Ejection fraction(EF)remained stable,however longitudinal systolic function significantly decreased with age from 7.9±1.8 to 6.6±1.4 cm/s2(P<0.0001).Diastolic function as assessed by increased E:e’(11.2±3.4 to 16±7.5,P<0.0001)and increased left atrial volume index(34.1±11.3 to 42.4±13.7 m L/m^2,P<0.0001)was reduced with aging.Conclusions This study demonstrated preserved EF with decreased longitudinal systolic function and diastolic function without significant change in LV mass.Changes in LV function in the very elderly may be independent of changes in LV geometry.
文摘BACKGROUND Chronic mitral regurgitation(MR)is a volume overload state that causes dilatation of the left sided cardiac chambers.The presence of significant dilatation is considered an indication for mitral valve intervention,however,aging may affect left ventricular(LV)remodeling independently of valvular disease.The objective of this study was to examine age-related changes in cardiac remodeling in a broad population of patients with chronic MR.METHODS Consecutive subjects that underwent echocardiography examinations recorded in the echocardiography database of a university-affiliated laboratory were retrieved.Subjects were categorized into none/mild,moderate or severe MR.For purposes of analysis of differences with aging,the population was divided into groups above and below 70 years of age and standard echocardiographic measurements were compared between the groups.RESULTS A total of 3492 subjects with at least moderate MR(mean age:76 years,52%female)were included in the study and compared to 18,250 subjects with none or mild MR.Older patients had significantly smaller LV end-diastolic diameters and volumes and significantly larger left atrial(LA)volumes when compared to the younger group.LA volume index increased in both age groups as MR severity increased,while LV end-diastolic volume increased with increasing MR only in the younger population.CONCLUSIONS Cardiac remodeling in chronic MR is significantly influenced by age.Guideline based recommendations of timing of mitral valve interventions in asymptomatic MR patients,based on assessment of LA and LV remodeling,may need to take age into account.
