# Association between frailty and echocardiographic findings in hospitalized older adults with preserved ejection fraction

## TL;DR

Frailty in older adults is linked to heart function issues, even when heart pumping is normal, showing structural and functional changes in the heart.

## Contribution

This study demonstrates that frailty independently predicts diastolic dysfunction and cardiac structural changes in older adults with preserved ejection fraction.

## Key findings

- Frailty is strongly associated with diastolic dysfunction (adjusted odds ratio of 3.49).
- Frail individuals show larger atrial volumes and smaller ventricular volumes.
- Pulmonary artery systolic pressure and tricuspid regurgitation velocity are elevated in frail patients.

## Abstract

This study aims to examine the association between frailty and cardiac structure and function in hospitalized older adults with preserved ejection fraction, using echocardiographic parameters and the Fried frailty index.

A cross-sectional analytical study was conducted in two referral centres. A total of 269 individuals aged 60 years or older were included. The exclusion criteria were conditions that affect ventricular mechanics. Patients were categorized into non-frail, prefrail, and frail groups. Transthoracic echocardiography included 2D imaging, Doppler, and Global Longitudinal Strain (GLS) of the left ventricle. Comparative analysis was considered statistically significant if P < 0.05. Frailty was significantly associated with diastolic dysfunction, with an adjusted odds ratio of 3.49 (95% CI: 1.90–6.39, P < 0.001). After adjusting for potential confounders—including age, hypertension, diabetes mellitus, coronary heart disease, chronic obstructive pulmonary disease, and chronic kidney disease—frailty remained strongly associated with diastolic dysfunction. In addition, frail patients exhibited distinctive cardiac structural changes, including larger atrial volumes and smaller ventricular volumes. Pulmonary artery systolic pressure and tricuspid regurgitation velocity were also significantly elevated in frail individuals, while GLS of the left ventricle did not differ between groups.

Frailty is independently associated with diastolic dysfunction. Even after adjusting for key comorbidities, it remains strongly associated with significant structural and functional cardiac alterations in hospitalized older adults with preserved ejection fraction.

Graphical Abstract