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

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.

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.

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.

Impaired GLS was associated with low physical performance among older inpatients with preserved ejection fraction.