Cardiac structure and function and renal insufficiency in the oldest old

Area of Science:

• Gerontology
• Cardiology
• Nephrology

Background:

• Individuals over 85 years old have a high prevalence of cardiovascular disease and chronic kidney disease.
• Renal function is increasingly recognized as a factor influencing cardiac health in the elderly population.

Purpose of the Study:

• To investigate the association between renal function and cardiac structure and function in individuals aged 85 years and older.
• To determine if reduced glomerular filtration rate (GFR) impacts cardiac parameters in the oldest old.

Main Methods:

• Recruited 310 subjects aged 85 from the Jerusalem Longitudinal Cohort Study.
• Assessed cardiac structure and function using echocardiography.
• Calculated estimated glomerular filtration rate (eGFR) using the Cockcroft-Gault formula, defining abnormal eGFR as ≤60 mL/min/1.73 m(2).

Main Results:

• A statistically significant but weak association was observed between eGFR as a continuous variable and left atrial volume, left ventricular mass index, and ejection fraction.
• No significant relationship was found between eGFR and diastolic function indices when treated as a continuous variable.
• Using a clinical cutoff of eGFR ≤60 mL/min/1.73 m(2), no significant differences in cardiac structure or function were found between subjects with normal and abnormal renal function.

Conclusions:

• A weak, clinically insignificant association exists between continuous eGFR and cardiac function indices in the very elderly.
• Clinically relevant thresholds of abnormal renal function do not appear to be associated with altered cardiac structure or function in this age group.