Potential role of conventional and speckle-tracking echocardiography in the screening of structural and functional cardiac abnormalities in elderly individuals: Baseline echocardiographic findings from the LOOP study

PLoS One. 2022 Jun 3;17(6):e0269475. doi: 10.1371/journal.pone.0269475. eCollection 2022.

Abstract

Background: Elderly individuals occupy an increasing part of the general population. Conventional and speckle-tracking transthoracic echocardiography may help guide risk stratification in these individuals. The purpose of this study was to evaluate the potential utility of conventional and speckle-tracking echocardiography in the screening of cardiac abnormalities in the elderly population.

Methods: Two cohorts of elderly individuals (sample size: 1441 and 944) were analyzed, who were part of a randomized controlled clinical trial (LOOP study) and of an observational study (Copenhagen City Heart Study), recruiting participants from the general population >70 years of age with cardiovascular risk factors (arterial hypertension, diabetes mellitus, heart failure, or prior stroke) and sinus rhythm. Participants underwent a comprehensive transthoracic echocardiographic examination, including myocardial speckle tracking. Cardiac abnormalities were defined according to the ASE/EACVI guidelines.

Results: Structural cardiac abnormalities such as left ventricular (LV) remodeling, mitral annular calcification (MAC), and aortic valve sclerosis (with or without stenosis) were highly prevalent in the LOOP study (40%, 39%, and 27%, respectively). Moreover, a high prevalence of functional cardiac alterations such as LV diastolic dysfunction (LVDD), abnormal LV longitudinal systolic strain (GLS), and abnormal left atrial (LA) reservoir strain was present in the LOOP study (27%, 18%, and 9%, respectively). Likewise, the rate of LVDD, abnormal GLS, and abnormal LA reservoir strain was comparable in the validation sample from the Copenhagen City Heart Study. In line with these findings, subjects with LV remodeling, MAC, and aortic valve changes had a higher prevalence of LVDD, abnormal GLS, and abnormal LA reservoir strain than those without structural cardiac alterations.

Conclusion: The findings of this study highlight the potential clinical utility of conventional and speckle-tracking echocardiography in the screening of structural and functional cardiac abnormalities in the elderly population. Further studies are warranted to determine the prognostic relevance of these findings.

Publication types

  • Observational Study
  • Randomized Controlled Trial
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Aged
  • Calcinosis*
  • Echocardiography
  • Heart Atria
  • Heart Defects, Congenital*
  • Humans
  • Ventricular Dysfunction, Left*
  • Ventricular Function, Left
  • Ventricular Remodeling

Grants and funding

The LOOP study received funding from the Innovation Fund Denmark (Innovationsfonden), the Research Foundation for the Capital Region of Denmark (Region Hovedstaden), the Danish Heart Foundation (Hjerteforeningen), Aalborg University Talent Management Programme, and the Arvid Nilsson Foundation and Medtronic. Dr. Olsen received funding from the Copenhagen University Hospital - Herlev and Gentofte, Kong Christian den Tiendes Fond, Fru Asta Florida Bolding Mindelegat, and the Danish Heart Foundation (Hjerteforeningen) (Grant no.: 18-R125-A8534-22083). Dr. Biering-Sørensen received funding from the Copenhagen University Hospital - Herlev and Gentofte, Fondsbørsvekselerer Henry Hansen og Hustrus Hovedlegat, the Lundbeck foundation (Lundbeckfonden), and the Novo Nordisk Foundation (Novo Nordisk fonden). The funders had no role in study design, data collection and analysis, decision to publish, or preparation of the manuscript.