住院老年人左心室整体纵向应变与身体表现相关。

IF 4.3

Experimental gerontology Pub Date : 2025-09-09 DOI:10.1016/j.exger.2025.112890

Yu Song , Pan Liu , Yumeng Chen , Bixi Li , Ou Zhao , Ying Li , Yun Li , Lina Ma

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引用次数: 0

摘要

背景：老年人身体机能低下与不良临床结果相关。全局纵向应变（GLS）是心功能障碍的敏感指标，已被证明比标准超声心动图参数提供更大的预测价值。然而，它与老年人身体表现的关系尚不清楚。方法：共纳入274例年龄≥60 岁、左室射血分数≥50 %的住院患者。采用斑点跟踪超声心动图测量GLS。采用短体能测试（SPPB）对被试进行体能测试，并将被试分为活动受限组（SPPB≤9）和活动正常组（SPPB >9）。比较两组患者的临床特征、超声心动图参数和老年评估。采用Logistic回归、受限三次样条和亚组相互作用分析来检验GLS与身体表现之间的关系。结果：活动受限的患者年龄较大，GLS受损，营养状况较差，虚弱评分较高，多种用药的患病率较高。逻辑回归显示，随着GLS的恶化，活动受限的几率逐渐增加。在完全调整的多变量模型中，GLS最差四分位数的参与者与最佳四分位数的参与者相比，优势比为4.21（95 %置信区间：1.57-11.33,P = 0.004）。限制三次样条分析显示，GLS与SPPB、步态速度和椅子上升测试时间之间存在显著的线性相关。亚组分析显示，年龄、性别和合并症之间没有显著的相互作用。结论：在保留射血分数的老年住院患者中，GLS受损与身体机能低下有关。

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Left ventricular global longitudinal strain is associated with physical performance in hospitalized older adults

Background

Low physical performance is associated with adverse clinical outcomes among older adults. Global longitudinal strain (GLS), a sensitive indicator of cardiac dysfunction, has been shown to provide greater predictive value than standard echocardiographic parameters. However, its association with physical performance in older adults remains unclear.

Methods

A total of 274 hospitalized patients aged over 60 years with a left ventricular ejection fraction ≥50 % were enrolled. GLS was measured using speckle-tracking echocardiography. Physical performance was evaluated using the Short Physical Performance Battery (SPPB), and participants were categorized into two groups: those with mobility limitation (SPPB ≤9) and those with normal mobility (SPPB >9). Clinical characteristics, echocardiographic parameters, and geriatric assessments were compared between the two groups. Logistic regression, restricted cubic spline, and subgroup interaction analyses were performed to examine the association between GLS and physical performance.

Results

Patients with mobility limitations were older and exhibited impaired GLS, worse nutritional status, higher frailty scores, and a greater prevalence of polypharmacy. Logistic regression revealed a graded increase in the odds of mobility limitation with worsening GLS. In the fully adjusted multivariate model, participants in the worst GLS quartile had an odds ratio of 4.21 (95 % confidence interval: 1.57–11.33, P = 0.004) compared to those in the best quartile. Restricted cubic spline analysis showed a significant linear association between GLS and SPPB, gait speed, and chair-rise test time. Subgroup analyses revealed no significant interactions by age, sex, and comorbidities.