Abstract 17616: Increased Cardiovascular Stiffness and Impaired Age-Related Functional Status

Abstract

Background: It has been shown increased cardiac and aortic stiffness is independently associated with reduced peak exercise capacity in the elderly. We hypothesized that increased cardiovascular (CV) stiffness was associated with decreased functional status in the elderly.

Methods: We measured pulse pressure/left ventricular stroke volume indexed to body surface area in 362 elderly individuals (81% Caucasian, 17% Black, 2% other) at risk for, but yet to experience an episode of heart failure. Each subject underwent magnetic resonance imaging (MRI) on a 1.5-T scanner with a phased array cardiac surface coil. Multislice, multiphase, cine white blood images were acquired using steady-state free precession to assess LV volumes. On the day of MRI, participants completed a functional assessment (19 questions from the Fitness Arthritis and Seniors Trial-23 questionnaire). Total overall score was calculated, as well as individual scores for activities of daily living, mobility, and instrumental activities of daily living. Questions were answered on a scale of 1 to 5, 5 indicating most difficulty.

Results: The mean age of our cohort was 69 ± 8 years. 47% were men (69 ± 8 years), 53% were women (69 ± 8 years). Mean BMI was 30.3 ± 6.3, mean heart rate was 65 ± 11, and mean blood pressure was 141 ± 17/79 ± 13. 92% had hypertension, 40% had diabetes mellitus, and 24% had coronary artery disease. The mean CV stiffness was 1.70±0.56. The mean overall functional scale score was 1.52±0.59. The mean total mobility score was 1.84±0.89. Before accounting for age or gender, overall functional score worsened with increased CV stiffness (r=0.131, P= 0.013). This correlation (r) was also present between the mobility score and CV stiffness (r=0.151, P=0.004), and held after accounting for age (0.123, P=0.019). After stratifying for gender, the correlations between CV stiffness with overall functional and mobility scores remained significant for men (r=0.223, P=0.003 and r=0.237, P=0.002, respectively) but not for women.

Conclusion: In a group of elderly subjects at high risk for development of heart failure, cardiovascular stiffness correlates with and may contribute to a decreased functional status in men independent of age. In women this correlation exists, but is confounded by age.