Cardiac Structure and Function and Renal Insufficiency in the Oldest Old

Authors

  • David Leibowitz MD,

    Corresponding author
    1. Jerusalem Institute of Aging Research, Hadassah-Hebrew University Medical Center, Jerusalem, Israel
    2. Heart Institute, Hadassah-Hebrew University Medical Center, Jerusalem, Israel
    • David Leibowitz, MD Coronary Care Unit Hadassah-Hebrew University Medical Center Mount-Scopus Jerusalem, 91240 Israel
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  • Yoram Maaravi MD,

    1. Jerusalem Institute of Aging Research, Hadassah-Hebrew University Medical Center, Jerusalem, Israel
    2. Department of Geriatrics and Rehabilitation, Hadassah-Hebrew University Medical Center, Jerusalem, Israel and
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  • Irit Stessman-Lande BMedSc,

    1. Heart Institute, Hadassah-Hebrew University Medical Center, Jerusalem, Israel
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  • Jeremy M. Jacobs MBBS,

    1. Jerusalem Institute of Aging Research, Hadassah-Hebrew University Medical Center, Jerusalem, Israel
    2. Department of Geriatrics and Rehabilitation, Hadassah-Hebrew University Medical Center, Jerusalem, Israel and
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  • Dan Gilon MD,

    1. Heart Institute, Hadassah-Hebrew University Medical Center, Jerusalem, Israel
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  • Jochanan Stessman MD

    1. Jerusalem Institute of Aging Research, Hadassah-Hebrew University Medical Center, Jerusalem, Israel
    2. Department of Geriatrics and Rehabilitation, Hadassah-Hebrew University Medical Center, Jerusalem, Israel and
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Abstract

Background:

People over the age of 85 years have a high incidence of cardiovascular disease and chronic kidney disease.

Hypothesis:

There is an association between renal function and cardiac structure and function in subjects 85 years of age.

Methods:

Subjects born in the years 1920 and 1921 were recruited from the Jerusalem Longitudinal Cohort Study. Echocardiography was performed at the subject's home with assessment of cardiac structure and function. Glomerular filtration rate (GFR) was assessed by the Cockroft-Gault formula, with abnormal GFR defined as ≤60 mL/min/1.73 m2.

Results:

There were 310 subjects who were enrolled. When GFR was examined as a continuous variable, linear regression showed a small although statistically significant relationship between GFR and left atrial volume (r = 0.15, P < 0.014), left ventricular mass index (r = 0.12, P < 0.04), and ejection fraction (r = 0.19, P < 0.03) but not with indices of diastolic function (r = 0.02, P < 0.72). However, using the accepted clinical cutoff of 60 mL/min/1.73 m2, there were no significant differences between subjects with normal and abnormal GFR in indices of cardiac structure. Ejection fraction (57.0 ± 10.4% vs 54.4 ± 10.3%; P = 0.08) and indices of diastolic function (E/e′ 12.4 ± 5.0 vs 12.3 ± 4.6; P = 0.89) were not significantly different between the 2 groups.

Conclusions:

A weak and clinically insignificant association was found between GFR as a continuous variable and indices of cardiac function. However, using the clinically accepted cutoff, no association between abnormal GFR and cardiac structure or function was observed.

David Leibowitz, MD, and Yoram Maaravi, MD, contributed equally to this report.

The authors have no funding, financial relationships, or conflicts of interest to disclose.

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