Age-related Ventricular Remodeling is an Independent Risk for Heart Failure Symptoms in Subjects With Preserved Systolic Function

Abstract

s u m m a r y Background: Age has been shown to be related with increased vascular stiffness, cardiac structural alterations, and geometric remodeling. Data regarding the relationship between clinical heart failure (HF) symptoms and aging-related alterations of ventricular geometries are scarce. We therefore investigated this issue. Methods: We subsequently studied 1,577 participants without cardiovascular or chronic lung disorders. Echocardiography-defined cardiac structures and left ventricular (LV) geometries, including LV mass, relative wall thickness, and mass-to-volume ratio were all determined. Baseline clinical variables, medical histories, and functional impairment in terms of HF symptoms during exercise were all obtained. Multivariate bootstrapping derived odds ratio from various models were used to represent the independent predictors for HF. Results: Of all, 1,459 participants (age: 49.3 AE 10.8; 36% female) with normal ejection fraction (66.8 AE 4.7%) were enrolled in our study. Cardiac structural alterations, ventricular geometric remodeling, and diastolic dysfunction were significantly related to aging process, along with increasing cardiovascular morbidities and risk factors. After adjusting for confounders and LV mass, change in ventricular geometries in terms of mass-to-volume ratio remained an independent risk, whereas relative wall thickness had a borderline significance for HF symptoms (odds ratio: 2.79 and 1.04, p ¼ 0.047 and 0.08, respectively). Conclusion: Cardiac structure, function, and various ventricular remodeling patterns were age-related. Such remodeling process is not only associated with a higher incidence of cardiovascular morbidities but also more likely to develop HF symptoms, which are independent of clinical variables and LV mass.

Effect of the number of parity on right heart chamber quantification

“…We did not use this classification in study but increasing BMI itself was found as independent risk factor for RV dilation. Again, in line with our study, it has shown in many studies that several structural and functional cardiac alterations are age-related irrespective of comorbidities (23)(24).…”

Effect of the number of parity on right heart chamber quantification

“…We did not use this classification in study but increasing BMI itself was found as independent risk factor for RV dilation. Again, in line with our study, it has shown in many studies that several structural and functional cardiac alterations are age‐related irrespective of comorbidities 26,27 …”

“…Again, in line with our study, it has shown in many studies that several structural and functional cardiac alterations are age-related irrespective of comorbidities. 26,27 Although relation between the number of parity and estimated PAP was found statistically significant, there was not any value exceeding 35 mm Hg. Additionally, we did not measure pulmonary artery mean and/or diastolic pressures, therefore we could not diagnose pulmonary hypertension via these measurements.…”

Critical appraisal of the role of serum albumin in cardiovascular disease

“…In the Cardiovascular Health Study, enrolling 5450 healthy individuals aged ≥65 years, hypoalbuminemia was found to be significantly associated with incident HF in 10 years by using propensity matched analysis [ 68 ]. Since the established study reported a significant association between echocardiographic parameters and HF, the impact of SA on cardiac dysfunction should be investigated [ 69 ]. This would not only elucidate the link between SA and HF but also aid early detection of subclinical cardiac dysfunction in healthy individuals.…”