Effect of anticholinergic burden on cardiac functions in older patients.

Abstract

Background: This study investigated the detrimental effects of a high anticholinergic burden on both myocardial systolic-diastolic functions and electrical functions in older adults.

Methods: A total of 24 patients with a high anticholinergic burden and 26 control patients were enrolled. The anticholinergic burden was assessed using the anticholinergic burden (ACB) scale. An ACB of ≥ 2 was categorized as high anticholinergic burden, while those with an ACB score of 0 were included in the control group. Each participant's diastolic and systolic functions were evaluated using transthoracic two-dimensional, conventional and tissue Doppler echocardiography. Heart rate and corrected QT interval (cQT) were also measured to assess electrophysiological changes.

Results: The mean age was 72.5 ± 6.6 years. Biventricular systolic and diastolic functions were impaired in the high ACB patients. Systolic function parameters such as lateral‑S (8.04 ± 1.43 vs. 9.54 ± 1.82, p = 0.003), septal‑S (7.33 ± 0.64 vs. 8.27 ± 1.31, p = 0.007) and tricuspid‑S (12.42 ± 1.72 vs. 14.31 ± 3.17, p = 0.025) values were lower in the ACB patients compared to the control group. The indicator of left ventricular (LV) filling pressure (E/E') was higher in ACB patients than in the controls (11.61 ± 2.89 vs. 8.83 ± 1.68, p < 0.001). There was no significant difference in terms of heart rate and cQT. Serum albumin levels were lower in ACB patients comparing to controls (4.08 ± 0.33 vs. 4.38 ± 0.27, p = 0.001).

Conclusion: A high anticholinergic burden is associated with moderately impaired systolic and diastolic functions, yet on its own, it does not sufficiently explain the increased hospitalization and mortality observed in older adults.