Abnormal ECG, aortic regurgitation common among centenarians

BARCELONA, Spain — A study of centenarians showed that the majority had an abnormal ECG and approximately half had aortic regurgitation, according to findings presented at ESC Congress.

Manuel Martínez-Sellés, MD, and colleagues analyzed data from the Cardiac and Clinical Characterization of Centenarians (4C) registry to glean knowledge about the aging process and identify areas for treatment and prevention. Data on cardiac anatomy, physiology and pathophysiology in centenarians are scarce, Martínez-Sellés, from Hospital Gregorio Marañón and Universidad Europea de Madrid, said at a press conference.

The prospective registry included 118 centenarians (90 women) at nine Spanish centers assessed from April 2011 to March 2013.

In terms of clinical characteristics, 31% of participants had good nutritional status, 28% had no cognitive impairment, 64% had a first-degree relative aged 90 years or older, 11% were independent in all aspects of daily living, and 57% could not walk 6 m, according to Martínez-Sellés.

Factors associated with the ability to walk 6 m included nutritional assessment (OR=1.3; 95% CI, 1.1-1.5) and LV dilation (OR=0.09; 95% CI, 0.01-0.76), he said.

Most participants had an abnormal ECG, with only 9% of men and 31% of women having a normal one (P for interaction between sexes=.01), while 23% presented with atrial fibrillation or atrial flutter, 15% presented with left bundle branch block and 9% presented with right bundle branch block, Martínez-Sellés said.

Among the 85% of participants in whom echocardiography was performed, the most frequent condition present was aortic regurgitation in 49% (36% mild, 11% moderate, 2% severe), while 16% presented with moderate or severe aortic stenosis, 15% presented with mitral insufficiency and more than two-thirds had some form of diastolic dysfunction.

Also, he said, “the presence of aortic regurgitation was associated with mortality.” The OR was 1.8 (95% CI, 1.31-2.5).

“Severe abnormalities in echocardiography were associated with the ability to walk and with mortality, and I think this is very important,” Martínez-Sellés said. “Our data show that there exists an age-related effect on the heart, and that this influences not only functional status but also the prognosis of centenarians. We think that this effect could be taken into account in the development of possible strategies to prevent or mitigate it.”

For more information:

Martínez-Sellés M. Abstract 2249. Presented at: the European Society of Cardiology Congress; Aug. 30-Sept. 3, 2014; Barcelona, Spain.

Disclosure: Martínez-Sellés reports no relevant financial disclosures.