Hosamadin S Assadi, Xiaodan Zhao, Gareth Matthews, Rui Li, Jordi Broncano Cabrero, Bahman Kasmai, Samer Alabed, Javier Royuela Del Val, Hilmar Spohr, Yashoda Gurung-Koney, Nay Aung, Sunil Nair, Andrew J Swift, Vassilios S Vassiliou, Liang Zhong, Abdallah Al-Mohammad, Rob J van der Geest, Peter P Swoboda, Sven Plein, Pankaj Garg
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引用次数: 0
Abstract
Aims: Cardiac ageing involves a series of anatomical and physiological changes contributing to a decline in overall performance. Cardiac magnetic resonance (CMR) provides comprehensive structural and functional assessment for detecting age-related cardiovascular remodelling. We aimed to develop a fully automated CMR model to predict functional heart age.
Methods and results: This international, multi-centre, retrospective observational study enrolled 191 healthy individuals with normal body mass index (BMI), free of metabolic, cardiovascular, and respiratory disease as the derivation cohort. Left atrial (LA) end-systolic volume and LA ejection fraction were selected for the final model. The model was validated on 366 patients with BMI >25 kg/m2 and one or more comorbidities [hypertension, diabetes mellitus (DM), atrial fibrillation (AF), and obesity]. In healthy individuals [median age: 34 years, 105 (55%) female], CMR-derived functional heart age was similar to the chronological age [bias: 0.05%, 95% confidence interval (CI): 9.56-9.67%, P = 0.993]. In the validation cohort [median age: 53 years, 157 (43%) female], CMR-derived functional heart age was 4.6 years higher than chronological age (95% CI: 1.6-7.6 years, P = 0.003). Cardiac magnetic resonance-derived functional heart age was significantly higher in patients with hypertension (P < 0.001), DM (P < 0.001), and AF (P < 0.001) than age-matched healthy controls. Moreover, CMR-derived functional heart age was higher than the chronological age in obesity Class I (P = 0.07), obesity Class II (P = 0.11), and obesity Class III (P < 0.001).
Conclusion: This study highlights the time course of structural and physiological changes in the heart during healthy and unhealthy ageing. We propose simple equations that should help communicate subtle changes in heart assessment with ageing.
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