Structural and functional cardiac parameters in older adults residing in a long-term social care facility

The aging of the population is accompanied by an increase in the prevalence of chronic heart failure, including those with preserved ejection fraction, which necessitates the early detection of structural and functional changes in the myocardium in the elderly and senile, especially in long-term care facilities. The aim of the study was to identify the features of the structural and functional state and diastolic function of the myocardium in elderly and senile patients with various rehabilitation profiles according to transthoracic echocardiography. The study included residents of the residential care home for the elderly and disabled No. 1 in St. Petersburg, divided into cognitive, motor and mixed rehabilitation groups. All participants underwent transthoracic echocardiography with an assessment of the size of the chambers of the heart, the thickness of the interventricular septum and the posterior wall of the left ventricle, myocardial mass, ejection fraction, parameters of diastolic function and indicators of pulmonary hemodynamics. All the examined patients showed age-associated signs of thickening of the walls and an increase in the relative thickness of the myocardium. At the same time, the severity of diastolic dysfunction and signs of pulmonary hypertension was statistically significantly higher in the cognitive and mixed groups compared with the motor ones. Against the background of preserved systolic function, hemodynamically significant disorders of diastolic filling were recorded in a significant proportion of patients, indicating early stages of heart failure with preserved ejection fraction. The data obtained confirm the expediency of including echocardiographic indicators in the algorithms of clinical and functional stratification of elderly patients and planning personalized medical and social rehabilitation programs in the long-term care system.