The Correlation Between Frailty And Left Ventricular Diastolic Function In Elderly Patients With Normal Left Ventricular Systolic Function

Objective:This study was aims to explore thecorrelation between the degree of frailty and left ventricular diastolic function in elderly patients with normal left ventricular ejection fraction(LVEF?50%).By analyzing the echocardiographic parameters of patients with diffeent degrees of frailty,including left ventricular conventional parameters and left ventricular diastolic function parameters,to further understand the impact of frailty on cardiac function,Especially for left ventricular diastolic function,to quantify the effect of frailty on diastoli,c function,This study also collected N-terminal B-type natriuretic p.eptide(NT-proBNP),which combined with the left ventricular diastolic function to predict the risk of the occurrence of heart failure with reserved ejection fraction(HFrEF).Analyze and demonstrate that frailty is a risk factor for HFrEF,and expect to help guide clinical work.Methods:A total of 100 hospitalized geriatric pat.ients aged over 60 years were collected from February to November 2018 in the Department of Geriatrics,First Hospital of Shanxi Medical University,The Fried Scale was used to assess the patients's frailty.According to the scoring criteria:0 points is no frailty group(group A),<3 points pre-frailty is group(group B),3 points is frailty group(group C),The conventional cardiac function parameters of all patients were measured:eject;ion fraction(LVEF),left ventricular end-diastolic diameter(LVDD),left ventricular end-systolic diameter(LVSD),left ventricular end-diastolic volume(EDV),left ventricular end-systolic volume(ESV),fractional shortening(FS),mitral E peak flow velocity(E),and mitral A peak blood flow velocity(A),average velocities of the septal and lateral sides of the mitral annulus(e'),than calculating the E/A,E/e'.The general information and related biochemical indicators were collect:total cholesterol(TC),triglyceride(TG),high density lipoprotein(HDL-C),low density lipoprotein(LDL-C),ho mocysteine(Hcy)and N-terminal-pro-brain natriuretic peptide(NT-proBNP).Statistical method was used to analyze the correlation between the degree of frailty and the above related indicators.Statistical analysis was performed using SPSS 22.0 statistical software.The Measurement data were described by x±s.The sample normality test was performed using the Kolmogorov-Smirnov test,NT-proBNP did not conform to the normal distribution,Logarithmically transformed into a normal distribution and then analyzed for variance,and the median(interquartile range)was used for description.For the continuous variables with normal distribution and homogeneity of variance,one-way ANOVA was used for comparison between groups:The count data is expressed as a percentage(%)and the comparison between the groups is performed by chi-square test.Fisher's test for groups with a theoretical frequency<5?The correlation between the Frailty score and left ventricular dias tolic function was analyzed by Spearman correlation analysis.The difference was statistically significant atP<0.05.Results:Among 100 elderly hospitalized patients,25(25%),50(50%)and 25(25%)were in group A,B and C respectively.As the degree of Frailty increases,the age increases,and the difference is statistically significant(F=5.894 P=0.004),There was no significant difference in gender and combined underlying disease among the groups(P>0.05).The level of NT-proBNP increased with the degree of frailty,and the difference was statistica lly significant(F=9.051,P=000).The TC level of group B was higher than that of group C,and the difference was statistically significant(F-3.72 P=0.028).There were no significant differences in remaining biochemical parameters and left ventricular conventional echocardiographic parameters between the groups(P>0.05).E/A of each group is less than 1,and e' is less than 7cmls.The relationship between debilitating and left ventricular diastolic function after age stratification was shown:In patients younger than 80 years old,the E/e' value increased with the increase of the degree of frailty(F=15.196,P=000),there was no significant difference in e' and E/A between the 3 groups(P>0.05);In patients aged 80 years and older,as the degree of frailty increased,the value decreased,and the E/e'value increased,the difference was statistically significant(F=11.038,8.799,P=0.002,0.006),and the difference of E/A between the three groups was not statistically significant(P>0.05);Spearman correlation analysis showed that there was a negative correlation between the Frailty score and the e' value,the differ ence was statistically significant(rs=-0.340,P=0.001);there was no c.orrelation with E/A(rs=-0.047,P=0.645);There was a positive correlation with E/e' and the difference was statistically significant(rs=0.642,P=0.000).Conclusion:For elderly patients with normal left ventricular systolic function,the incidence of left ventricular diastolic dysfunction is high;The degree of frailty is related to the severity^of PDD;frailty may be one of the risk factors for HFpEF.