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Correlation between frailty and cardiac structure and function in echocardiography in elderly patients with normal ejection fraction

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Abstract

Objective

This study aims to accurately evaluate the cardiac structure and function of the frail population in elderly patients with normal ejection fraction (EF) using the 3D volume quantification and speckle tracking of echocardiography, to explore the correlation between frailty and cardiac structure and function.

Methods

A total of 350 elderly aged 65 and above in-patients, excluding those with congenital heart disease, cardiomyopathy, and severe valvular heart disease, were included in the study. Patients were divided into non-frail, pre-frail, and frail group. Echocardiography techniques including speckle tracking and 3D volume quantification, were used to analyze the cardiac structure and function of the study subjects. Comparative analysis was statistically significant if P < 0.05.

Results

The cardiac structure of the frail group was different compared with non-frail patients, the frail group demonstrated increased left ventricular myocardial mass index (LVMI), but decreased stroke volume. Cardiac function was also impaired in the frail group: reservoir strain and conduit strain of left atrium, strain of right ventricular (RV) free wall, strain of RV septum, 3D EF of RV, and global longitudinal strain of LV were significantly decreased. Frailty was significantly and independently associated with LV hypertrophy (OR 1.889; 95% CI 1.240,2.880; P = 0.003), LV diastolic dysfunction (OR 1.496; 95% CI 1.016,2.203; P = 0.041), left ventricular global longitudinal strain (LVGLS) reduction (OR 1.697; 95% CI 1.192, 2.416; P = 0.003), and reduced RV systolic function (OR 2.200; 95% CI 1.017, 4.759; P = 0.045).

Conclusion

Frailty is closely associated with several heart structural and functional alterations, which not only manifested as LV hypertrophy and reduced LV systolic function, but also decreased LV diastolic function, RV systolic function, and left atrial systolic function. Frailty is an independent risk factor for LV hypertrophy, LV diastolic dysfunction, LVGLS reduction, and reduced RV systolic function.

Trial registration number

ChiCTR2000033419. Date of registration: May 31, 2020.

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Data availability

The datasets used during the current study are available from the corresponding author on reasonable request.

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Funding

This study was supported by National Clinical Research Center for Geriatrics, West China Hospital, Sichuan University (Z20192010).

Author information

Authors and Affiliations

  1. Department of Cardiology and National Clinical Research Center for Geriatrics, West China Hospital, Sichuan University, Sichuan, China

    Li Xi & Wei Xin

  2. Department of Cardiology, West China Hospital of Sichuan University, Chengdu, China

    Zhong Xuemei, Yan Ling, Chen Changchun & Qin Jinyang

  3. Department of Cardiology, West China Tianfu Hospital of Sichuan University, Chengdu, China

    Hou Zhuo

Authors
  1. Li Xi
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  2. Zhong Xuemei
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  3. Yan Ling
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  4. Chen Changchun
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  5. Hou Zhuo
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  6. Qin Jinyang
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  7. Wei Xin
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Corresponding author

Correspondence to Wei Xin.

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Conflict of interest

All authors declare they have no conflict of interest to disclose.

Ethics approval and consent to participate

This study was conducted in accordance with the declaration of Helsinki. This study was conducted with approval from the Ethic committee of West China Hospital, Sichuan University.

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Written informed consent to publish the clinical details and images of the patient was obtained.

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Xi, L., Xuemei, Z., Ling, Y. et al. Correlation between frailty and cardiac structure and function in echocardiography in elderly patients with normal ejection fraction. Aging Clin Exp Res 35, 775–784 (2023). https://doi.org/10.1007/s40520-023-02363-5

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  • DOI: https://doi.org/10.1007/s40520-023-02363-5

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