Echocardiographic Findings in Persons Aged 90 Years of Older

In order to evaluate changes in the cardiac shape, structure, and function (remodeling) caused by aging, we analyzed the echocardiographic and Doppler findings of 42 patients, aged 90 years or older (mean 92 years, range 90-98; 14 men). Of the 42 patients, 19 (45 %) had hypertension, 9 (20 %) had coronary artery disease, 5 (14 %) had a history of myocardial infarction, 10 (23 %) had clinically significant valvular heart disease, and 3 (7 %) had hypertrophic cardiomyopathy. Left ventricular (LV) mass index was above normal in 34 (81 %) patients. The angle between the septum and the aorta was 87±17 degrees and 108±14 degrees in end-diastole and end-systole, respectively. In 21 (50 %) patients It was seen that a proximal septal bulge protruded into the left ventricular outflow tract. There was LV outflow tract obstruction in two patients. Aortic regurgitation was detected in 25 patients (60 %). It was 3+ in one patient. Mitral regurgitation was detected in 19 patients (45 %). It was 3 or 4+ in six patients. Tricuspid regurgitation was noted in 17 patients (40 %). It was 3 or 4+ in three patients. Aortic stenosis was detected in 18 patients (43 %), in seven patients the instantaneous gradient was >50 mmHg. Stenotic or regurgitant lesion was present in one valve in 12 patients, two valves in 15 patients, and three valves in 11 patients. There was no valvular lesion in four patients. Our data suggest that advancing age causes structural changes in the cardiac valves and alterations in the cardiac shape. However, these changes are not functionally significant in most of these elderly cases.