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[Characteristics of myocardial diseases in the elderly]
Y Sugishita1, K Iida, Y Iwasaki
1Department of Internal Medicine, University of Tsukuba.
Insights
Elderly patients with dilated cardiomyopathy (DCM) show increased heart wall thickness, while hypertrophic cardiomyopathy (HCM) patients exhibit decreased thickness. Adaptive changes may improve survival in these myocardial diseases.
Area of Science:
- Cardiology
- Internal Medicine
Context:
- Myocardial diseases encompass cardiomyopathies of unknown and known origins.
- Dilated cardiomyopathy (DCM) and hypertrophic cardiomyopathy (HCM) are primary forms.
- Cardiac amyloidosis is prevalent in elderly patients with known myocardial diseases.
Purpose:
- To analyze the clinical courses of 120 cardiomyopathy patients, comparing young-middle-aged and elderly groups.
- To investigate age-related differences in DCM and HCM progression and clinical presentation.
Summary:
- Elderly patients with DCM showed increased left ventricular posterior wall thickness and left atrial diameter.
- Younger HCM patients more frequently presented with obstructive disease compared to the elderly.
- Hypertension history was more common in middle-aged/elderly individuals.
- Elderly patients with DCM exhibited increased left ventricular end-diastolic diameter and decreased wall thickness.
Impact:
- Understanding age-related adaptations in myocardial diseases like DCM and HCM is crucial.
- Adaptive mechanisms, such as altered ventricular dimensions and wall thickness, may influence survival.
- This research highlights potential therapeutic targets for improving long-term outcomes in cardiomyopathy patients.
Abstract:
Myocardial diseases consist of cardiomyopathy of unknown origin and specific myocardial diseases of known origin. The former consists mainly of dilated cardiomyopathy (DCM) and hypertrophic cardiomyopathy (HCM). In the latter, cardiac amyloidosis may be most frequently seen in the elderly. One hundred and twenty patients with cardiomyopathy were studied concerning their clinical courses. They were divided into 2 groups; i) young-middle-aged (Y) and ii) elderly (0). Group 1 was divided into 2 subgroups: 1a) followed up to an age less than 60 years old, and 1b) followed up to beyond age 60. In DCM, left ventricular posterior wall thickness and left atrial diameter increased significantly in the elderly. In HCM, young patients had obstructive type disease more frequently than the elderly. A history of mild hypertension was found more frequently in the middle-aged or elderly than in the young. Left ventricular end-diastolic diameter increased and left ventricular wall thickness decreased significantly in the elderly. Many patients with DCM usually die of congestive heart failure with ventricular arrhythmia, and those with HCM, both young or middle-aged, often die suddenly during sports activity. If there is an adaptive system, such as increased wall thickness in DCM or decreased wall thickness and increased diameter in HCM, which may contribute to the normalization of left ventricular wall stress, the patients might be able to survive to old age.