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

Abstract

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±10.8; 36% female) with normal ejection fraction (66.8±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=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.

Keywords

• aging
• left ventricular remodeling
• heart failure