Betancourt Daniel, Zuluaga Jose, Arango Fernando, Murillo Tatiana, Hincapié Daniel
Research Group on Geriatrics and Gerontology, Faculty of Health Sciences, Universidad de Caldas, Carrera 25 # 48-57, Manizales 170004, Colombia.
Department of Cardiology, SES Hospital Universitario de Caldas, Universidad de Manizales, Calle 72 # 25-75, Manizales 170004, Colombia.
Eur Heart J Open. 2025 Jul 4;5(4):oeaf087. doi: 10.1093/ehjopen/oeaf087. eCollection 2025 Jul.
This study aims to examine the association between frailty and cardiac structure and function in hospitalized older adults with preserved ejection fraction, using echocardiographic parameters and the Fried frailty index.
A cross-sectional analytical study was conducted in two referral centres. A total of 269 individuals aged 60 years or older were included. The exclusion criteria were conditions that affect ventricular mechanics. Patients were categorized into non-frail, prefrail, and frail groups. Transthoracic echocardiography included 2D imaging, Doppler, and Global Longitudinal Strain (GLS) of the left ventricle. Comparative analysis was considered statistically significant if < 0.05. Frailty was significantly associated with diastolic dysfunction, with an adjusted odds ratio of 3.49 (95% CI: 1.90-6.39, < 0.001). After adjusting for potential confounders-including age, hypertension, diabetes mellitus, coronary heart disease, chronic obstructive pulmonary disease, and chronic kidney disease-frailty remained strongly associated with diastolic dysfunction. In addition, frail patients exhibited distinctive cardiac structural changes, including larger atrial volumes and smaller ventricular volumes. Pulmonary artery systolic pressure and tricuspid regurgitation velocity were also significantly elevated in frail individuals, while GLS of the left ventricle did not differ between groups.
Frailty is independently associated with diastolic dysfunction. Even after adjusting for key comorbidities, it remains strongly associated with significant structural and functional cardiac alterations in hospitalized older adults with preserved ejection fraction.
本研究旨在利用超声心动图参数和弗里德衰弱指数，探讨射血分数保留的住院老年患者衰弱与心脏结构和功能之间的关联。
在两个转诊中心进行了一项横断面分析研究。共纳入269名60岁及以上的个体。排除标准为影响心室力学的疾病。患者被分为非衰弱、衰弱前期和衰弱组。经胸超声心动图包括二维成像、多普勒检查以及左心室整体纵向应变（GLS）。若P<0.05，则认为比较分析具有统计学意义。衰弱与舒张功能障碍显著相关，校正后的优势比为3.49（95%可信区间：1.90 - 6.39，P<0.001）。在调整了包括年龄、高血压、糖尿病、冠心病、慢性阻塞性肺疾病和慢性肾脏病等潜在混杂因素后，衰弱仍与舒张功能障碍密切相关。此外，衰弱患者表现出独特的心脏结构变化，包括心房容积增大和心室容积减小。衰弱个体的肺动脉收缩压和三尖瓣反流速度也显著升高，而左心室GLS在各组之间无差异。
衰弱与舒张功能障碍独立相关。即使在调整了关键合并症后，它仍与射血分数保留的住院老年患者显著的心脏结构和功能改变密切相关。
