Electrocardiographic Changes in Centenarians: A Study on 42 Subjects and Comparison with the Literature

Abstract

Background: Aging is associated with extensive and pervasive changes in cardiovascular structure and function, which may result in electrocardiographic alterations. The typical modifications seen in an electrocardiogram (ECG) in elders are: prolonged PR and QT intervals, QRS left-axis deviation and microvolt T wave. Several studies have included elderly people, but not long-living elderly and centenarians in particular who represent an increasing part of the population. Objective: The aim of this study was to investigate the electrocardiographic findings in a population of centenarians and to compare the results with the few studies present in the literature. Methods: We analyzed 42 healthy centenarians (12 males, 30 females; average age 101.43 ± 1.80 years) living in Messina, a municipality of Eastern Sicily, in Italy. They were clinically and functionally evaluated. All ECGs were analyzed by a single observer blind to clinical data. We assessed survival by phone recall. Results: PR interval mean duration was 190 ± 3.3 ms, QRS 90 ± 1.4 ms, QTc interval mean duration was 370 ± 3.5 ms. Entirely normal ECG recordings were found in 7 centenarians (16.6%). The most frequently observed abnormalities included left-axis deviation and left anterior hemiblock in 16 centenarians (38.09%), left ventricular hypertrophy and aspecific ST-T wave abnormalities in 13 subjects (30.95%). We found no statistically significant differences between men and women. The mean age at death was 102.44 ± 2.45, and we did not find significant differences in age at death in long-living elderly in relation to different electrocardiographic findings. Comparing our results with two previous studies in the literature, the first conducted in Switzerland [Cornu: Rev Med Suisse Rom 1979;99:107–113] and the second in Nebraska [Lakkireddy et al.: Am J Cardiol 2003;92:1249–1251], we found a higher frequency of left ventricular hypertrophy that was compatible with the prevalence of hypertension in our centenarians (33.3%). Moreover, we did not find left bundle branch block, and the frequency of premature beats was remarkably less than that observed in the Swiss and US studies. Conclusions: Considering the increasing rate of centenarians, we believe that the results of the present study on electrocardiographic changes in centenarians may also be useful in clinical practice.

Centenarians and their hearts: A prospective registry with comprehensive geriatric assessment, electrocardiogram, echocardiography, and follow-up

“…3,4,[12][13][14][15][16][17][18][19] For example, the frequency of atrial fibrillation varies from 0% to 30%, and that of myocardial infarction ranges from 0% to 20% (Table VI). There are several reasons for these differences, including different enrollment criteria.…”

“…All previous studies were single center, and most included fewer than 50 centenarians. 12,13,15,16,18 Some excluded centenarians with previous cardiac disease 12 and were performed retrospectively. 13,19 Our study was designed to avoid these biases and included a systematic approach to baseline health status, echocardiography, and follow-up.…”

“…12 However, previous ECG studies in centenarians are limited by low sample size and methodological biases. 3,4,[12][13][14][15][16][17][18][19] The echocardiographic characteristics of centenarians have only been reported in a small retrospective group of 63 hospitalized subjects. 20 The aim of this study was to describe ECG, echocardiography, and blood test results in a cohort of centenarians and to correlate them with survival and with clinical data obtained from the medical history and a comprehensive geriatric assessment.…”

Electrocardiographic Abnormalities in the Elderly: A Study in a Large Database of Primary Care Patients

“…Aging is associated with extensive changes in cardiovascular structure and function which may result in ECG abnormalities [11,12]. The clinical significance of many of these abnormalities is uncertain.…”

ECG low QRS voltage and wide QRS complex predictive of centenarian 360-day mortality

“…Survival prognosis of centenarians is especially important for making diagnostic and therapeutic decisions. Widespread specific cardiac anomalies have been documented by ECG in centenarians (Lakkireddy et al 2003; Rabunal-Rey et al 2012; Basile et al 2012). Survival and ECG associations have been studied by Rabunal-Rey et al (2012) who observed that atrial fibrillation is a prognostic factor for mortality and by Basile et al (2012) who did not describe any ECG findings that are predictive of survival.…”