ECHOCARDIOGRAPHIC, DOPPLER AND CLINICAL FINDINGS PREDICT SURVIVAL IN THE ELDERLY

Background The aim of the study was to assess whether clinical and ech ocardiographic data of left ventricular mass and function, and of left -sided heart valve disease, predict survival in a general aged populat ion. Methods A random population sample representing three elderly age cohorts (aged 75-76, 80-81 and 85-86 years, n=501) was examined using two-dimensional, M-mode and Doppler echocardiography to determine lef t ventricular mass, systolic function, diastolic function and the pres ence and severity of aortic and mitral valve disease, The study popula tion was followed for 4 years, and the causes of death were determined from census statistics and death certificates. Results Of the 501 par ticipants, 156 died (80 from cardiovascular causes) within 4 years, Th e multivariate risk ratios [95% confidence intervals (CI)] for cardiov ascular death adjusted for age and sex were 1.25 (95% CI 1.15-1.35) fo r each -5% difference in left ventricular fractional shortening, 1.08 (95% CI 1.02-1.14) for each +10 g/m difference in left ventricular mas s/height, and 2.16 (95% CI 1.32-3.56) for the presence of at least mod erate aortic or mitral valve disease. These factors maintained their p redictive value even when coronary artery disease, hypertension and co ngestive heart failure were entered into the analysis. The Doppler ind ices of left ventricular diastolic function had no prognostic signific ance. Conclusions We conclude that echocardiographic evidence of incre ased left ventricular mass, decreased systolic function and the presen ce of at least moderate aortic or mitral valve disease predict shorten ed survival in the general elderly population.