The normal cardiac index in older healthy individuals: a scoping review

Despite the growing number of older patients having major surgery, the normal resting values for the cardiac index of older patients remain unclear. We aim to derive a normative value for such patients.

Scoping review.

We searched MEDLINE, EMBASE and CENTRAL for studies reporting measured values of cardiac output or cardiac index in healthy, older humans at rest.

We retrieved 5340 citations and assessed 412 fulltext articles for eligibility. Twenty-nine studies, published between 1964 and 2017, met our inclusion criteria. Overall, the mean cardiac index in healthy volunteers over 60 years of age was reported between 2.1 and 3.2 L/min/m² and the mean cardiac output was between 3.1 and 6.4 L/min. A yearly decline in cardiac index (between 3.5 and 8 mL/min/m² per year) was reported in some but not all studies. Only one study measured the cardiac index in nine people over 80 years of age.

The normal range of the cardiac index in older patients may be lower than previously reported. Its rate of decline with age is uncertain, but likely between 3.5 and 8 mL/min/m² per year. Data on the normal cardiac index in people older than 80 years are scant.