Leibowitz David, Jacobs Jeremy M, Gilon Dan, Lande-Stessman Irit, Ein-Mor Eliana, Stessman Jochanan
Heart Institute, Hadassah-Hebrew University Medical Center and Hebrew University Hadassah Medical School, Jerusalem, Israel; Institute of Aging Research, Hadassah-Hebrew University Medical Center and Hebrew University Hadassah Medical School, Jerusalem, Israel.
Institute of Aging Research, Hadassah-Hebrew University Medical Center and Hebrew University Hadassah Medical School, Jerusalem, Israel; Department of Geriatrics and Rehabilitation, Hadassah-Hebrew University Medical Center and Hebrew University Hadassah Medical School, Jerusalem, Israel.
Am J Cardiol. 2016 Sep 1;118(5):760-4. doi: 10.1016/j.amjcard.2016.06.005. Epub 2016 Jun 14.
Frailty is a biologic syndrome reflecting a state of decreased physiological reserve of increasing importance in cardiovascular disease given the aging of the population. The relation between frailty and indexes of cardiac structure and function remains unclear, particularly in the "oldest old." The objective of this study was to examine the association between cardiac function and frailty in an age-homogenous, community-dwelling population of subjects aged 85 and 86 years. Subjects were recruited at ages 85 to 86 from the Jerusalem Longitudinal Cohort Study that has followed an age-homogenous cohort of Jerusalem residents. Subjects underwent echocardiography at their place of residence with standard assessment of cardiac structure and function. Frailty was defined according to the "phenotype of frailty" including at least 3 of the following: weakness, slowness, low physical activity level, exhaustion, and weight loss; 405 subjects (193 men and 212 women) were enrolled in the study. Subjects defined as frail had significantly lower ejection fraction compared with the non-frail group (53.7 ± 0.09% vs 56.4 ± 0.09%; p <0.04). In addition, frail subjects had increased LV mass index (130.6 ± 36.2 g/m(2) vs 119.2 ± 31.1 g/m(2); p <0.03) and LA volume index (41.9 ± 14.7 cm(3)/m(2) vs 36.7 ± 13.1 cm(3)/m(2); p <0.001). Indexes of diastolic function (E/e)' were not significantly different in the 2 groups (11.5 vs 11.8; p = NS). In this age-homogenous cohort of the oldest old, structural changes and indexes of systolic but not diastolic function were associated with frailty.
衰弱是一种生物学综合征，反映了生理储备下降的状态。鉴于人口老龄化，其在心血管疾病中的重要性日益增加。衰弱与心脏结构和功能指标之间的关系仍不明确，尤其是在“高龄老人”中。本研究的目的是在一个年龄同质、居住在社区的85岁和86岁人群中，研究心脏功能与衰弱之间的关联。研究对象从耶路撒冷纵向队列研究中85至86岁的人群中招募，该研究对一组年龄同质的耶路撒冷居民进行了随访。研究对象在其居住地接受了超声心动图检查，对心脏结构和功能进行了标准评估。衰弱根据“衰弱表型”定义，包括以下至少3项：虚弱、行动迟缓、低体力活动水平、疲惫和体重减轻；405名研究对象（193名男性和212名女性）参与了本研究。与非衰弱组相比，被定义为衰弱的研究对象射血分数显著更低（53.7±0.09%对56.4±0.09%；p<0.04）。此外，衰弱的研究对象左心室质量指数增加（130.6±36.2g/m²对119.2±31.1g/m²；p<0.03），左心房容积指数增加（41.9±14.7cm³/m²对36.7±13.1cm³/m²；p<0.001）。两组间舒张功能指标（E/e）'无显著差异（11.5对11.8；p=无统计学意义）。在这个年龄同质的高龄老人队列中，结构变化和收缩功能指标而非舒张功能指标与衰弱相关。
