Abstract
Background
Age-related changes in cardiac morphology and function have not been unknown in the elderly. The Japanese eLderly data Of Normal echocardioGraphy (J-LONG) study is a prospective multicenter cohort study and aimed to investigate the echocardiographic data in the healthy Japanese elderly.
Methods
Thirty domestic facilities participated in this study, and 130 healthy subjects (57 men, 73 women, 79.6 ± 4.7 years, range 75–98 years, interquartile range 76–82 years) were enrolled in this cohort. Echocardiographic and clinical data sets were obtained in each facility, and total analyses were performed in the University of Tsukuba.
Results
Almost all cardiac morphological data were significantly larger in men than those in women. However, corrected data by body surface area (BSA) were similar or closer between genders. As a gender difference, the negative correlation between BSA and age was observed in women only (r = − 0.46, p < 0.001), showing the independent determinant of women’s left ventricular end-diastolic volume (LVEDV) was age (β = − 0.29, p = 0.01), but not BSA. In men, LVEDV was significantly correlated with BSA (β = 0.42, p = 0.001), but not with age (p = 0.10).
Also, women had higher LV ejection fraction (70 ± 7.1 vs. 68 ± 4.9%, p = 0.02), lower E/A (0.67 ± 0.16 vs. 0.75 ± 0.21, p = 0.02), and higher E/eʹ (10 ± 2.7 vs. 8.9 ± 2.5, p = 0.03) as compared to men.
Conclusions
The J-LONG study suggested that correction by the physique was needed to interpret echocardiographic data of the elderly. Also, gender differences and age-related changes in cardiac morphology and function were observed, and further studies are needed to confirm the clinical significance.
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References
Suzuki T. Health status of older adults living in the community in Japan: recent changes and significance in the super-aged society. Geriatr Gerontol Int. 2018;18:667–77.
Lancellotti P, Seisyou K. Low-flow aortic stenosis and preserved left ventricular ejection fraction. J Echocardiogr. 2014;12:12–6.
Sato K, Seo Y, Ishizu T, et al. Prognostic value of global longitudinal strain in paradoxical low-flow, low-gradient severe aortic stenosis with preserved ejection fraction. Circ J. 2014;78:2750–9.
Kato M, Yamamoto K. Clinical characteristics of elderly patients with aortic stenosis. J Echocardiogr. 2015;13:134–40.
Shimura T, Yamamoto M, Kano S, OCEAN-TAVI Investigators, et al. Impact of the clinical frailty scale on outcomes after transcatheter aortic valve replacement. Circulation. 2017;135:2013–24.
Canepa M, Malti O, David M, et al. Prevalence, clinical correlates, and functional impact of sub-aortic ventricular septal bulge (from the Baltimore Longitudinal Study of Aging). Am J Cardiol. 2014;114:796–802.
Barasch E, Gottdiener JS, Larsen EK, et al. Clinical significance of calcification of the fibrous skeleton of the heart and aortosclerosis in community dwelling elderly. The Cardiovascular Health Study (CHS). Am Heart J. 2006;151:39–47.
Lang RM, Badano LP, Mor-Avi V, et al. Recommendations for cardiac chamber quantification by echocardiography in adults: an update from the American Society of Echocardiography and the European Association of Cardiovascular Imaging. J Am Soc Echocardiogr. 2015;28:1–39.
Nagueh SF, Smiseth OA, Appleton CP, et al. Recommendations for the evaluation of left ventricular diastolic function by echocardiography: an update from the American Society of Echocardiography and the European Association of Cardiovascular Imaging. J Am Soc Echocardiogr. 2016;29:277–314.
Rudski LG, Lai WW, Afilalo J, et al. Guidelines for the echocardiographic assessment of the right heart in adults: a report from the American Society of Echocardiography endorsed by the European Association of Echocardiography, a registered branch of the European Society of Cardiology, and the Canadian Society of Echocardiography. J Am Soc Echocardiogr. 2010;23:685–713.
Seino S, Shinkai S, Iijima K, et al. Reference values and age differences in body composition of community-dwelling older Japanese men and women: a pooled analysis of four cohort studies. PLoS ONE. 2015;10:e0131975. https://doi.org/10.1371/journal.pone.0131975.
Daimon M, Watanabe H, Abe Y, Japanese Normal Values for Echocardiographic Measurements Project (JAMP) Study Investigators, et al. Gender differences in age-related changes in left and right ventricular geometries and functions. Echocardiography of a healthy subject group. Circ J. 2011;75:2840–6.
Mason JW, Ramseth DJ, Chanter DO, et al. Electrocardiographic reference ranges derived from 79,743 ambulatory subjects. J Electrocardiol. 2007;40:228–34.
Palhares DMF, Marcolino MS, Santos TMM, et al. Normal limits of the electrocardiogram derived from a large database of Brazilian primary care patients. BMC Cardiovasc Disord. 2017;17:152. https://doi.org/10.1186/s12872-017-0572-8.
Kannel WB, Kannel C, Paffenbarger RS Jr, et al. Heart rate and cardiovascular mortality: the Framingham Study. Am Heart J. 1987;113:1489–94.
Lam CSP, Arnott C, Beale AL, et al. Sex differences in heart failure. Eur Heart J. 2019;40:3859–68.
Pieske B, Tschöpe C, de Boer RA, et al. How to diagnose heart failure with preserved ejection fraction: the HFA-PEFF diagnostic algorithm: a consensus recommendation from the Heart Failure Association (HFA) of the European Society of Cardiology (ESC). Eur Heart J. 2019;40:3297–317.
Acknowledgements
The J-LONG Study investigators are as follows: Masako Asakawa (JR Tokyo General Hospital, Tokyo), Chikage Oshita (JR Hiroshima Hospital, Hiroshima), Masanori Takada (Kawasaki Hospital, Hyogo), Mitsufumi Furuya (Koyama Memorial Hospital, Ibaraki), Fumiko Sakamaki, Hitomi Hashimoto (Tsukuba Central Hospital, Ibaraki), Takako Minami (Nagasaki University Hospital, Nagasaki), Harutoshi Tamura (Yamagata University School of Medicine, Yamagata), Akiko Okunaga, Yuichi Oshima (Kinki Central Hospital, Hyogo), Yoshie Omori (Nikko Memorial Hospital, Hokkaido), Takuma Aoyama (Kizawa Memorial Hospital, Gifu), Takako Iino (Akita University Graduate School of Medicine, Akita), Makoto Saito (Kitaishikai Hospital, Ehime), Tetsuya Kasuga (Nanpeidai Medical Clinic, Ibaraki), Taro Minagawa (Minagawa Clinic, Gifu), Satoshi Kibira (Kibira Medical Clinic, Akita), Hidekazu Tanaka (Kobe University Graduate School of Medicine, Hyogo), Yoshihisa Horizoe (Ebino City Hospital, Miyazaki), Hiroyoshi Yamamoto, Shintaro Beppu (Osaka Minato Central Hospital), Misun Pak (Shimane University Faculty of Medicine, Shimane), Miyako Nagumo (National Hospital Organization Saitama Hospital, Saitama), Masaki Izumo (St. Marianna University School of Medicine, Kanagawa), Atsushi Kobayashi (Fukushima Medical University, Fukushima), Shohei Kikuchi (Nagoya City University Graduate School of Medical Sciences, Aichi), Noriaki Iwahashi (Yokohama City University Medical Center, Kanagawa), Kotaro Numaguchi (National Hospital Orga nization Kyushu Medical Center, Fukuoka), Toshinari Onishi (Osaka University Graduate School of Medicine, Osaka), Yuki Izumi (Nippon Medical School, Tokyo), Hirotsugu Yamada, Kenya Kusunose (Tokushima University Graduate School of Biomedical Sciences, Tokushima), Hideo Kawakami (Ehime Prefectural Imabari Hospital, Ehime), and Hiroyuki Iwano (Faculty of Medicine and Graduate School of Medicine, Hokkaido University, Hokkaido).
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This study was approved as an academic project of the Japanese Society of Echocardiography and was supported by a grant from the Japanese Society of Echocardiography. Besides, this study was supported by JSPS KAKENHI Grant Number JP16K09417.
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All procedures followed were in accordance with the ethical standards of the responsible committee on human experimentation (institutional and national) and with the Helsinki Declaration of 1964 and later versions. Informed consent was obtained from all patients for being included in the study.
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The members of J-LONG Study investigators are listed in the Acknowledgements section.
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Seo, Y., Ishizu, T., Ieda, M. et al. Elderly Japanese Standard Data of Echocardiography; From J-LONG study. J Echocardiogr 18, 175–182 (2020). https://doi.org/10.1007/s12574-020-00469-7
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DOI: https://doi.org/10.1007/s12574-020-00469-7