Diagnosing heart failure in centenarians  

作　　者：Signe Hoi Rasmussen Karen Andersen-Ranberg Jordi Sanchez Dahl Mads Nybo Bernard Jeune Kaare Christensen Sabine Gill 

机构地区：[1]Danish Aging Research Center,Department of Public Health,University of Southern Denmark,Odense,Denmark [2]Department of Geriatrics,Odense University Hospital,Odense,Denmark [3]Department of Cardiology,Odense University Hospital,Odense,Denmark [4]Department of Clinical Biochemistry and Pharmacology,Odense University'Hospital,Odense,Denmark [5]Max-Planck Odense Center on the Biodemography of Aging,University of Southern Denmark,Odense,Denmark

出　　处：《Journal of Geriatric Cardiology》2019年第1期1-11,共11页老年心脏病学杂志（英文版）

基　　金：support from the Novo Nordisk Foundation;the Faculty of Health Sciences, University of Southern Denmark;the Health Foundation (Helsefonden) (Grant No.16B-0271);the Lundbeck Foundation (Grant No. R260-2017722);supported by a grant from the Velux Foundation

摘　　要：Background As a consequence of the demographic development with increasing proportion of older people,the prevalence of heart failure(HF)is expected to rise with considerable economic and societal costs.However,knowledge on cardiac structure and function among population-based samples of the exceptional old is lacking.Methods Population-based study of all persons(no exclusion criteria)living in the western part of Denmark and turning 100 years in the year 2015.In-home face-to-face interviews were conducted,and echocardiography and blood sampling for plasma Brain Natriuretic Peptide(BNP)were offered to those who were able to give consent.Results Out of 303 eligible,238(79%)participated,of which 125(53%)accepted echocardiography.Left ventricular(LV)dysfunction was present in 68(54%)of the participants of whom less than half had HF symptoms.Pulmonary hypertension was present in 31(42%)with no correlation to LV function.The well-known association between increased level of BNP and the prevalence of LV dysfunction could not be confirmed.Conclusions This in-home echocardiographic study shows that more than half of the participants had LV dysfunction,although mostly asymptomatic.There was no association between heart failure symptoms and LV dysfunction.Furthermore,BNP seems to have lost its biomarker potential to rule out heart failure in centenarians.Due to the latter,and the questionable symptom validity among centenarians,the current criteria to diagnose HF might be less valid in a centenarian population than in younger olds.Background As a consequence of the demographic development with increasing proportion of older people, the prevalence of heart failure(HF) is expected to rise with considerable economic and societal costs. However, knowledge on cardiac structure and function among population-based samples of the exceptional old is lacking. Methods Population-based study of all persons(no exclusion criteria) living in the western part of Denmark and turning 100 years in the year 2015. In-home face-to-face interviews were conducted, and echocardiography and blood sampling for plasma Brain Natriuretic Peptide(BNP) were offered to those who were able to give consent. Results Out of 303 eligible, 238(79%) participated, of which 125(53%) accepted echocardiography. Left ventricular(LV) dysfunction was present in 68(54%) of the participants of whom less than half had HF symptoms. Pulmonary hypertension was present in 31(42%) with no correlation to LV function. The well-known association between increased level of BNP and the prevalence of LV dysfunction could not be confirmed. Conclusions This in-home echocardiographic study shows that more than half of the participants had LV dysfunction, although mostly asymptomatic. There was no association between heart failure symptoms and LV dysfunction. Furthermore, BNP seems to have lost its biomarker potential to rule out heart failure in centenarians. Due to the latter, and the questionable symptom validity among centenarians, the current criteria to diagnose HF might be less valid in a centenarian population than in younger olds.

关 键 词：Brain NATRIURETIC Peptide CENTENARIAN Heart failure In-home ECHOCARDIOGRAPHY Left VENTRICULAR dysfunction 

分 类 号：R[医药卫生]