title: Cardiac structure and function as predictors of mortality in persons 85 years of age.
abstract: Individuals aged > 85 years are the world's most rapidly growing age group and have a high incidence of cardiovascular mortality. The objective of this study was to prospectively determine the prognosis of abnormal cardiac structure and function in an age-homogenous, community-dwelling population of subjects born in 1920 and 1921. Subjects were recruited from the Jerusalem Longitudinal Cohort Study. Echocardiography was performed with a portable echocardiograph at the subjects' places of residence. Standard echocardiographic assessment of cardiac structure and function was performed. Five-year mortality was assessed through a centralized government database. Five hundred two subjects (235 men, 267 women) were enrolled in the study, of whom 107 (21%) had died at the time of 5-year follow-up. Subjects who died had significantly higher left atrial volume indexes (42.3 ± 16.5 vs 36.6 ± 12.5 ml/m2, p < 0.01) and left ventricular mass indexes (133.1 ± 47.6 vs 119.8 ± 30.6 g/m2, p < 0.05). Ejection fractions were significantly lower in subjects who died (52.5 ± 11.5% vs 56.4 ± 9.4%, p < 0.003), but indexes of left ventricular diastolic function were not significantly different between the 2 groups (E/e' ratio 13.0 ± 5.3 vs 12.2 ± 4.9, p = 0.18). In conclusion, elevated left atrial volume index and left ventricular mass index and decreased LV systolic function predicted 5-year mortality in a community-dwelling population of subjects aged 85 years, even after correction for possible confounders. Left ventricular diastolic dysfunction did not predict 5-year mortality in this cohort.
authors.affiliation: Heart Institute, Hadassah-Hebrew University Medical Center and Hebrew University Hadassah Medical School, Mount Scopus, Jerusalem, Israel. oleibo@hadassah.org.il
authors.forename: David
authors.initials: D
authors.lastname: Leibowitz
authors.forename: Irit
authors.initials: I
authors.lastname: Stessman-Lande
authors.forename: Jeremy M
authors.initials: JM
authors.lastname: Jacobs
authors.forename: Aaron
authors.initials: A
authors.lastname: Cohen
authors.forename: Eliana
authors.initials: E
authors.lastname: Ein-Mor
authors.forename: Jochanan
authors.initials: J
authors.lastname: Stessman
authors.forename: Dan
authors.initials: D
authors.lastname: Gilon
mesh_terms: D000367:Age Factors; D000369:Aged, 80 and over; D002318:Cardiovascular Diseases / Q000000981:diagnostic imaging / Q000401:mortality* / Q000503:physiopathology; D002423:Cause of Death / Q000639:trends; D004452:Echocardiography; D005500:Follow-Up Studies; D006352:Heart Ventricles / Q000000981:diagnostic imaging* / Q000503:physiopathology; D006801:Humans; D007557:Israel / Q000453:epidemiology; D008297:Male; D011379:Prognosis; D011446:Prospective Studies; D015996:Survival Rate / Q000639:trends; D013997:Time Factors; D016276:Ventricular Function / Q000502:physiology*