Circulation Journal
Online ISSN : 1347-4820
Print ISSN : 1346-9843
Imaging
Prognostic Value of Frailty and Diastolic Dysfunction in Elderly Patients
Kenya KusunoseYuichiro OkushiHirotsugu YamadaSusumu NishioYuta ToriiYukina HirataYoshihito SaijoTakayuki IseKoji YamaguchiShusuke YagiTakeshi SoekiTetsuzo WakatsukiMasataka Sata
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2018 Volume 82 Issue 8 Pages 2103-2110

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Abstract

Background:High prevalence of frailty and of diastolic dysfunction (DD) in heart failure and high mortality in frail adults have been noted. We characterized frailty by quantifying differences on echocardiography, and assessed the added prognostic utility of frailty and DD grade in an elderly population.

Methods and Results:One hundred and ninety-one patients ≥65 years who had at least 1 cardiovascular risk factor were prospectively recruited for clinically indicated echocardiography at the present institute. Weight loss, exhaustion, and deficits in physical activity, gait speed, and handgrip strength were used to categorize patients as frail (≥3 features), intermediately frail (1 or 2 features), or non-frail (0 features). DD grade ≥2 was defined as severe. Frailty was associated with larger left atrial volume, smaller stroke volume, and worse DD grade after adjustment for age. In a period of 14 months, 29 patients (15%) had cardiovascular events. The addition of frailty score and severe DD significantly improved the prognostic power of a model containing male gender (model 1, male gender, χ2=6.4; model 2, model 1 plus frailty score, χ2=16.7, P=0.004; model 3, model 2 plus severe DD, χ2=25.5, P=0.015).

Conclusions:Both frailty and DD grade were significantly associated with future cardiovascular events in an elderly population with preserved ejection fraction and ≥1 risk factor of cardiovascular disease.

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© 2018 THE JAPANESE CIRCULATION SOCIETY
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