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Research Article
 
DOI:10.11909/j.issn.1671-5411.2019.11.004
Longitudinal changes in cardiac function in the very elderly: the Jerusalem longitudinal cohort study
David Leibowitz,Irit Stessman-Lande,Hend Sliman,Jeremy M Jacobs,Jochanan Stessman,Dan Gilon.Longitudinal changes in cardiac function in the very elderly: the Jerusalem Longitudinal Cohort StudyJ Geriatr Cardiol 2019,16(11):800~805
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Authors:David Leibowitz1;Irit Stessman-Lande2;Hend Sliman2;Jeremy M Jacobs3;Jochanan Stessman3;Dan Gilon4

Author Affiliation:1.Jerusalem Institute of Aging Research, Hadassah-Hebrew University Medical Center, Mount-Scopus, Jerusalem, Israel; Coronary Care Unit, Hadassah–Hebrew University Medical Center, Mount-Scopus, Jerusalem, Israel;2.Coronary Care Unit, Hadassah–Hebrew University Medical Center, Mount-Scopus, Jerusalem, Israel;3.Jerusalem Institute of Aging Research, Hadassah-Hebrew University Medical Center, Mount-Scopus, Jerusalem, Israel; Department of Geriatrics and Rehabilitation, Hadassah-Hebrew University Medical Center, Mount-Scopus, Jerusalem, Israel;4.Coronary Care Unit, Hadassah–Hebrew University Medical Center, Mount-Scopus, Jerusalem, Israel

Foundation:

Abstract: 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 (HFpEF). 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 (32F, 31M) 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 mL (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 cc/m2, 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.

Keywords:

Echocardiography; The elderly; Ventricular function
Received:October 06, 2019        Accepted:November 24, 2019   Published Online:November 28, 2019
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