Electrocardiographic and Echocardiographic Findings in Patients Older than 60 Years: A One Year Pilot Study

Main Article Content

Ajala Aisha Oluwabunmi
Bell-Gam Hope Ilanye

Abstract

Background: Cardiovascular disease (CVD) is the most frequent diagnosis in elderly people and is the leading cause of death in both men and women older than 65 years of age. Age-related vulnerability to CVD is compounded by the cumulative effect of the normal aging process and cardiovascular risk factors over a lifetime. The study assessed the prevalence of electrocardiographic and echocardiographic abnormalities in patients older than 60 years at the geriatric unit of the University of Port-Harcourt Teaching Hospital.

Methods: A cross-sectional study was conducted over 50 patients admitted to the geriatric ward over one year. The subjects underwent blood pressure and anthropometric parameters clinical examinations. Evaluation of the cardiovascular system was done using resting electrocardiogram and echocardiography.

Results: The mean age of the subjects was 68.3±6.3 years with a female preponderance. Out of the 50 studied patients, 44 were admitted with a diagnosis of heart failure (HF). Preserved ejection fraction was present in 27 out of the 44 patients admitted for HF. Forty-seven patients had an abnormal LV geometry ranging from concentric remodeling to eccentric LV hypertrophy. Diastolic dysfunction was present in majority of the respondents 42 (84%). Resting ECG showed varying degrees of rhythm disturbances. Sinus tachycardia, bradycardia and left anterior fascicular blocks were the most prevalent rhythm disorders. Electrocardiographic LVH and left atrial abnormalities were present in 21 and 27 patients respectively. Prolonged QTc was present in only 4 patients.

Conclusion: Electrocardiographic and ultrasound abnormalities are common in elderly patients and this also reflects the high prevalence of CVD in these groups of patients. Thus, resting ECG and ultrasound should routinely be incorporated as one of the baseline assessments for elderly patients to identify potentially serious heart conditions and also serves as a basis for comparison during subsequent hospitalization.

Keywords:
Elderly, cardiovascular disease, ECG, echo, Nigeria

Article Details

How to Cite
Oluwabunmi, A. A., & Ilanye, B.-G. H. (2020). Electrocardiographic and Echocardiographic Findings in Patients Older than 60 Years: A One Year Pilot Study. Cardiology and Angiology: An International Journal, 9(3), 8-17. https://doi.org/10.9734/ca/2020/v9i330135
Section
Original Research Article

References

Naja S, Din Makhlouf MM El, Chehab MAH. An ageing world of the 21st century: A literature review. Int J Community Med Public Heal. 2017;4(12):4363.

Nations U, of Economic D, Affairs S, Division P. World Population Ageing. Highlights; 2019.

Lakatta EG. Central intelligence and the epidemic of systolic hypertension and atherosclerosis. Journal of the American Society of Hypertension. 2017;1:302-40.

Steppan J, Barodka V, Berkowitz DE, Nyhan D. Access to. Res Cardiol Res Pract. 2011;2011.

Safar ME, Levy BI, Struijker-Boudier H. Current perspectives on arterial stiffness and Pulse pressure in hypertension and cardiovascular diseases. Circulation. 2003; 107:2864- 9.

World Health Organisation. Double strategy on diet physical activity and health. Bulletin of the world Health Organisation Suppl. 2006;5:16-8.

Shiroma EJ, Lee IM. Physical activity and cardiovascular health: Lessons learnt from epidemiological studies across age, gender and racial/ ethnicity. Circulation. 2010;122:743-52.

Iloh GUP, Amadi AN, Chuku A, Ikwudinma AO, Nnorom OU. Predictors of abdominal obesity among adult Nigerians in a resource for environment of a rural hospital in Eastern Nigeria. British Journal of Medical Research. 2014;4:2369-82.

Iloh GUP, Ikwudinma AO. Abdominal obesity in adult Nigerian Africans: Prevalence and co-occurrence with cardiometabolic risk factors in a resource-poor setting of a rural hospitals in Eastern Nigeria. American Journal of Health Research. 2013;1:73-80.

Aronow Wilbert S. Lipid-lowering therapy in older persons. Archives of Medical Science: AMS. 2015;11(1):43-56.
DOI: 10.5114/aoms.2015.48148

Iloh G, Amadi AN, Njoku PU, Ofoedu JN, Awa-Madu J. The magnitude of abdominal adiposity and artherogenic dyslipidemia among geriatric Nigerians with arterial hypertension in a rural hospital in South Eastern Nigeria. Nigerian Journal of Clinical Practice. 2012;15:4628-8.

Yohei N, Taku I, Hideki I, Kyohei Y, Shun K, Mitsuaki S, et al. Comparison of outcomes after percutaneous coronary intervention in elderly patients, including 10 628 nonagenarians: Insights from a japanese nationwide registry (J‐PCI Registry). J Am Heart Assoc. 2019;8(5): e011183.

Huynh-Hohnbaum, Anh-Luu T, et al. Self-management of heart disease in older adults. Home Health Care Services Quarterly. 2015;34(3-4):159-72.
DOI: 10.1080/01621424.2015.1092909

Modin, Daniel, et al. Echo and heart failure: when do people need an echo and when do they need natriuretic peptides? Echo Research and Practice. 2018;5(2):R65-R79.
DOI: 10.1530/ERP-18-0004

Writing Group Members. Lloyd-Jones D, Adams RJ, et al. Heart disease and stroke statistics 2010 update: A report from the American heart Association. Circulation. 2010;121(7):e46-e215.

Lakatta EG, Levy D. Arterial and cardiac: Major shareholders in cardiovascular disease Enterprises: Part 2: The aging heart in health: Linked to heart disease. Circulation. 2003;107(2):346-354.

Lida P, Ba M, Mg A, Roy T, HK G, et al. Effect of physical activity on age-related changes in cardiac function and performance in women. Circ Cardiovasc Imaging. 2015;8(1):e002086.

Gerstenblith G, Frederiksen J, Yin F, Fortuin N. Echocardiographic assessment of a normal adult aging population. Circul Circulation; 1997.

Olivetti G, Melissari L, Capasso JM, Anversa P. Cardiomyopathy of the aging human heart. Myocyte loss and reactive cellular hypertrophy. Circ Res. 1991;68(6): 1560-1568.

Fleg JL, Lakatta EG. Normal aging of the cardiovascular system. Cardiovascular Diseases in the Elderly. 2007;1-46.

Bryg RJ, Williams GA, Labovitz AJ. Effects of agents on the left ventricular diastolic filling in normal subjects. American journal of Cardiology. 1987;59(9):971-974.

Browsers FP, Hillege HL, Van Gilst WH, Van Veldhuisen DJ. Comparing new-onset heart failure with reduced ejection fraction and new-onset heart failure with preserved ejection fraction: An epidemiologic perspective. Curr Heart Fail. 2012;9:363-368.

Lung B, Vahanian A. Epidemiology of valvular heart disease in the adult. Natt Rev Cardiol. 2011;8:162-72.

Roberts WC, Virmani R. Aschoff bodies at necropsy in valvular heart disease. Evidence from an analysis of 543 patients over 14 years of age that rheumatic heart disease, at least anatomically is a disease of the mitral valve. Circulations. 1978;57: 803-7.

Nkomo VT, Gardin JM, Skelton TN, et al. Burden of valvular heart diseases: A population-based study. The Lancet. 2006; 368:1005-1011.

Nishimura RA, Tajik AJ. Quantitative hemodynamics by Doppler echocardio-graphy: A non-invasive alternative to cardiac catheterization. Prog Cardiovasc Dis. 1994;36:309-342.

Oyedeji AT, Akintunde AA, Owojori OO, Peter JO. Spectrum of echocardiographic abnormalities among 168 consecutive referrals to an urban Private Hospital in south-western Nigeria. Clin Med insights Cardiol. 2014;8(8):35–8.

Bhata N, Brass SS, Skolmck AH, Wenger NK. Aortic valve disease in the older adult. J Geriatr Cardiol. 2016;13(12):941-944.

Strauss SM, Bluemink GS, Dielenian JP, et al. The incidence of sudden cardiac death in the general population. J Clin Epidemiol. 2004;57:98-102.

Fleg JL, Strait J. Age-associated changes in cardiovascular structure and function: A fertile milieu for future disease. Heart Fail Rev. 2012;17:545-554.

Goldstein DR, Jalife J. Synergistic research between the centre of original research and the Michigan biology of cardiovascular agents at the University of Michigan. Circ Res. 2017;121: 1221-3.

Sutton R. Mobitz type 1 second degree atrioventricular block: The value of permanent pacing in the older patient. Heart. 2013;99:291-2.