From geriatric assessment to inflammation. A pilot, observational, study about frailty components in older patients with persistent atrial fibrillation

IF 2.5 Q2 CARDIAC & CARDIOVASCULAR SYSTEMS

IJC Heart and Vasculature Pub Date : 2024-11-21 DOI:10.1016/j.ijcha.2024.101558

Stefano Fumagalli , Giulia Ricciardi , Claudia Di Serio , Elisa Berni , Giancarlo La Marca , Giuseppe Pieraccini , Riccardo Romoli , Emanuele Santamaria , Giulia Spanalatte , Camilla Cagnoni , Arianna Tariello , Giada Alla Viligiardi , Agostino Virdis , Igor Diemberger , Andrea Ungar , Niccolò Marchionni

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Abstract

Background

Atrial fibrillation (AF) is the most common arrhythmia diagnosed at an older age. AF is associated with frailty, a condition possibly justifying the higher rate of complications and mortality in aged individuals. This study was aimed at describing the characteristics correlated to frailty in older AF subjects.

Methods

After having excluded a < 3 months major surgery procedure, cancer or other conditions associated with activation of inflammation, and a life expectancy < 12 months, we consecutively enrolled patients ≥ 65 years with persistent AF. They underwent a Comprehensive Geriatric Assessment evaluation. In particular, Mini-Mental State Examination, 15-item Geriatric Depression Scale and Short-Physical Performance Battery (SPPB) described, respectively, cognitive profile, depressive symptoms and physical performance. A venous blood sample was collected to measure interleukin-6 (IL-6; marker of low-grade inflammation) and acylcarnitines, expression of mitochondrial dysfunction and abnormal energy production.

Results

Overall, 49 patients (mean age: 76 ± 6 years; women 30.6 %) were studied. Cluster analysis described two different patterns; the second (N = 18, 36.7 %), when compared to the first one (N = 31, 63.3 %), was characterized by a worse phenotype, identified by the simultaneous presence of lower body mass index, higher CHA₂DS₂-VASc score (index of clinical complexity), worse SPPB functional performance, and high IL-6 levels. Second cluster patients had a higher concentration of 13 of the 35 acylcarnitines evaluated and increased 5-year mortality. All these features can outline a frail condition.

Conclusions

Body size, clinical complexity, physical performance and low-grade inflammation seem to rapidly and adequately describe frailty.

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从老年评估到炎症。关于老年持续性心房颤动患者虚弱成分的试点观察研究

背景心房颤动（房颤）是老年人最常见的心律失常。房颤与体弱有关，这可能是老年人并发症和死亡率较高的原因。本研究旨在描述老年房颤受试者与虚弱相关的特征。方法在排除了接受过 3 个月大手术、癌症或其他与炎症激活相关的疾病以及预期寿命为 12 个月的患者后，我们连续招募了年龄≥ 65 岁的持续性房颤患者。他们接受了老年综合评估。其中，小型精神状态检查、15 项老年抑郁量表和短期体能测试（SPPB）分别描述了认知概况、抑郁症状和体能表现。采集静脉血样本是为了测量白细胞介素-6（IL-6，低度炎症的标志物）和酰基肉碱，它们是线粒体功能障碍和能量生成异常的表现。聚类分析描述了两种不同的模式；与第一种模式（N = 31，63.3%）相比，第二种模式（N = 18，36.7%）的表型特征更差，同时存在较低的体重指数、较高的 CHA2DS2-VASc 评分（临床复杂性指数）、较差的 SPPB 功能表现和较高的 IL-6 水平。在评估的 35 种酰基肉碱中，第二组患者的 13 种浓度较高，5 年死亡率也较高。结论体型、临床复杂性、体能表现和低度炎症似乎可以快速、充分地描述虚弱。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

IJC Heart and Vasculature Medicine-Cardiology and Cardiovascular Medicine

CiteScore

4.90

自引率

10.30%

发文量

216

审稿时长

56 days

期刊介绍： IJC Heart & Vasculature is an online-only, open-access journal dedicated to publishing original articles and reviews (also Editorials and Letters to the Editor) which report on structural and functional cardiovascular pathology, with an emphasis on imaging and disease pathophysiology. Articles must be authentic, educational, clinically relevant, and original in their content and scientific approach. IJC Heart & Vasculature requires the highest standards of scientific integrity in order to promote reliable, reproducible and verifiable research findings. All authors are advised to consult the Principles of Ethical Publishing in the International Journal of Cardiology before submitting a manuscript. Submission of a manuscript to this journal gives the publisher the right to publish that paper if it is accepted. Manuscripts may be edited to improve clarity and expression.