Echocardiographic heart ageing patterns predict cardiovascular and non-cardiovascular events and reflect biological age: the SardiNIA study

Age is a crucial risk factor for cardiovascular (CV) and non-CV diseases. As people age at different rates, the concept of biological age has been introduced as a personalized measure of functional deterioration. Associations of age with echocardiographic quantitative traits were analysed to assess...

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Published in:European journal of preventive cardiology Vol. 31; no. 6; p. 677
Main Authors: Ganau, Antonello, Orrù, Marco, Floris, Matteo, Saba, Pier Sergio, Loi, Federica, Sanna, Giuseppe D, Marongiu, Michele, Balaci, Lenuta, Curreli, Niccolò, Ferreli, Liana A P, Loi, Francesco, Masala, Marco, Parodi, Guido, Delitala, Alessandro P, Schlessinger, David, Lakatta, Edward, Fiorillo, Edoardo, Cucca, Francesco
Format: Journal Article
Language:English
Published: England 18.04.2024
Subjects:
Aging
Child
Echocardiography
Echocardiography, Doppler
Humans
Risk Factors
Ventricular Function, Left
Ageing heart
Cardiovascular disease
Biological age
Cardiovascular prevention
Echocardiography
Age-dependent diseases
ISSN:2047-4881, 2047-4881
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Summary:Age is a crucial risk factor for cardiovascular (CV) and non-CV diseases. As people age at different rates, the concept of biological age has been introduced as a personalized measure of functional deterioration. Associations of age with echocardiographic quantitative traits were analysed to assess different heart ageing rates and their ability to predict outcomes and reflect biological age. Associations of age with left ventricular mass, geometry, diastolic function, left atrial volume, and aortic root size were measured in 2614 healthy subjects. Based on the 95% two-sided tolerance intervals of each correlation, three discrete ageing trajectories were identified and categorized as 'slow', 'normal', and 'accelerated' heart ageing patterns. The primary endpoint included fatal and non-fatal CV events, and the secondary endpoint was a composite of CV and non-CV events and all-cause death. The phenotypic age of the heart (HeartPhAge) was estimated as a proxy of biological age. The slow ageing pattern was found in 8.7% of healthy participants, the normal pattern in 76.9%, and the accelerated pattern in 14.4%. Kaplan-Meier curves of the heart ageing patterns diverged significantly (P = 0.0001) for both primary and secondary endpoints, with the event rate being lowest in the slow, intermediate in the normal, and highest in the accelerated pattern. In the Cox proportional hazards model, heart ageing patterns predicted both primary (P = 0.01) and secondary (P = 0.03 to <0.0001) endpoints, independent of chronological age and risk factors. Compared with chronological age, HeartPhAge was 9 years younger in slow, 4 years older in accelerated (both P < 0.0001), and overlapping in normal ageing patterns. Standard Doppler echocardiography detects slow, normal, and accelerated heart ageing patterns. They predict CV and non-CV events, reflect biological age, and provide a new tool to calibrate prevention timing and intensity.
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ISSN:2047-4881
2047-4881
DOI:10.1093/eurjpc/zwad254