Aged heart due to obesity and poor lifestyle habits can add 5-45 years to its actual age
Cracking down on heart woes early is vital for nailing potential issues and discovering useful treatments. Recently, researchers analyzed a novel method to gauge a person's heart’s functional age versus their biological age.
By using cardiac magnetic resonance imaging (MRI), the team found that a contributor to an older-looking heart includes some common conundrums like obesity and Atrial Fibrillation (AFib), along with living an unhealthy lifestyle.
Results from this study can make a difference in early intervention before significant heart concerns surface. The study’s findings were published in the European Heart Journal Open.
Measuring heart’s functional age
In this retrospective observational study, researchers sought to establish a means of measuring the age of the heart and recognize distinctions between healthy and unhealthy aging processes. They noted that certain risk factors, such as high blood pressure, could speed up heart aging. One possible tool to examine the heart's look and performance is cardiac magnetic resonance imaging (MRI).
The researcher's recruited two groups: a healthy reference group of 191 subjects and a test group of 366 subjects with at least one comorbidity, like hypertension, diabetes, or obesity. They also pulled in another group of 25 individuals for preliminary external validation.
The MRI scanning process gathered information on several heart structure and function aspects. The data assisted developers in creating a model to compute the participants’ heart age and conduct statistical analyses.
The final model concentrated on left atrial end-systolic volume and left atrial ejection fraction. These factors represented the left upper chamber of the heart's functionality, showing a significant correlation with age in 169 healthy subjects.
Health issues associated with premature heart aging
Researchers uncovered that healthy participants’ heart ages matched their real age. In contrast, unhealthy participants saw a higher heart age compared to their chronological age. Using cardiac MRI, the researchers estimated the participants' heart ages to be almost five years older than their biological age.
Overweight individuals seemed to have an impact on functional heart age. A higher BMI led to a greater increase in heart years. Subjects with a BMI of 40 or more had a functional heart age that was 45 years higher than their actual age. Those with AFib also had a higher functional heart age compared to healthy participants.
In participants between 30 and 69, those with hypertension showed an increase in functional heart age compared to healthy participants within the same age group. Similarly, diabetes elevated functional heart age for participants in the age range of 30 to 69, with the most significant increase observed in the 40 to 49-year-old group.
Remarkably, in the 70+ age group, participants with diabetes and hypertension had lower functional heart ages than healthy participants of similar age.
Dr. Pankaj Garg, Associate Professor in Cardiovascular Medicine at the University of East Anglia in Norwich, UK, disclosed some key findings from the study:
"We have found an equation, essentially a simple math formula, that looks at pictures from heart MRI scans to figure out how old your heart appears. Healthy individuals' hearts match their real age, but if someone has conditions such as high blood pressure, diabetes, an irregular heartbeat, or extra weight, their heart might look more than 4.6 years older, on average. For individuals with a significant amount of extra weight, their hearts might look up to 45 years older!" - Dr. Pankaj Garg, Associate Professor in Cardiovascular Medicine
Study limitations
Though this study presents an exciting step forward in heart health monitoring, it does have constraints. First, researchers based their findings on estimates of the functional age of the heart. Second, since the study wasn't long-term, there's a higher risk of survivor bias. In turn, this may minimize the actual impact of comorbidities on older adults. Third, researchers didn't quantify how long participants had had the measured comorbidities. Thus, there could be variation among individuals who exhibit unhealthy behaviors concerning exposure to these complications. Furthermore, some bias is evident in calculations, and there is potential for selection and validation bias.
Uninvolved cardiologist Dr. Patrick Kee acknowledged several potential limitations of the study: the absence of long-term data, the lack of additional measurements that could have been helpful, and the simple model's focus on left atrium end-diastolic volume and left atrium ejection fraction.
Future studies will benefit from long-term data, and insights regarding the impact of lifestyle changes on outcomes are keenly anticipated.
"The model was preliminarily validated on a small cohort, necessitating larger-scale validation to confirm its reliability and robustness for clinical application. Furthermore, it remains uncertain whether lifestyle and therapeutic interventions will alter the trajectory of heart age due to underlying medical conditions," states Dr. Patrick Kee.
Possible benefits for detection and improved heart health
Cheng-Han Chen, a board-certified interventional cardiologist and medical director of the Structural Heart Program at MemorialCare Saddleback Medical Center in Laguna Hills, CA, provided insights into the potential benefits of determining a heart’s functional age:
"Measuring a 'functional heart age' (either through imaging or other biomarkers) can potentially inspire patients to improve their lifestyles, identify patients at risk for future cardiovascular events, and possibly even evaluate the effectiveness of preventive strategies and interventions. MRI scans are completely non-invasive, allowing for quick scanning and available to many individuals, which may facilitate early diagnosis and mitigation of heart trouble.” – Cheng-Han Chen
Understanding the discrepancy between a patient's functional and chronological age can offer valuable insights for clinical decision-making and fostering structured discussions with patients, emphasizing the significance of adopting a healthy lifestyle and taking appropriate measures to manage comorbidities.
Tracking changes over time allows doctors to adjust treatment plans before permanent damage occurs.
- This novel method of gauging a person's heart’s functional age versus their biological age could be crucial for early detection and management of other heart diseases.
- Seniors are particularly vulnerable to heart woes, making it essential to identify potential issues early.
- The researchers used cardiac magnetic resonance imaging (MRI) to examine the heart's appearance and performance.
- The team recruited two groups: a healthy reference group and a test group with at least one comorbidity.
- Data from the MRI scans assisted in creating a model to compute the participants’ heart age.
- The final model focused on left atrial end-systolic volume and left atrial ejection fraction.
- These factors showed a significant correlation with age in healthy subjects.
- Overweight individuals had a higher impact on functional heart age.
- A higher BMI led to a greater increase in heart years for these individuals.
- Subjects with a BMI of 40 or more had a functional heart age that was 45 years higher than their actual age.
- Those with Atrial Fibrillation (AFib) also had a higher functional heart age.
- Hypertension increased functional heart age for participants between 30 and 69.
- Diabetes also elevated functional heart age, with the most significant increase observed in the 40 to 49-year-old group.
- Remarkably, in the 70+ age group, participants with diabetes and hypertension had lower functional heart ages than healthy participants of similar age.
- Researchers based their findings on estimates of the functional age of the heart.
- The study didn't account for long-term data, increasing the risk of survivor bias.
- Researchers didn't quantify how long participants had had the measured comorbidities.
- There could be variation among individuals who exhibit unhealthy behaviors concerning exposure to these complications.
- Some bias is evident in calculations, and there is potential for selection and validation bias.
- Uninvolved cardiologist Dr. Patrick Kee acknowledged several potential limitations of the study.
- The absence of long-term data was one of the limitations.
- Lack of additional measurements that could have been helpful was another issue.
- A simple model's focus on left atrium end-diastolic volume and left atrium ejection fraction was also criticized.
- Future studies will benefit from long-term data and insights regarding the impact of lifestyle changes on outcomes.
- Dr. Patrick Kee also highlighted the need for larger-scale validation to confirm the reliability and robustness of the model for clinical application.
- The model's uncertainty in predicting whether lifestyle and therapeutic interventions will alter the trajectory of heart age due to underlying medical conditions was another point of concern.
- Cheng-Han Chen, a board-certified interventional cardiologist, suggested that measuring a 'functional heart age' could inspire patients to improve their lifestyles.
- It could also potentially identify patients at risk for future cardiovascular events.
- MRI scans, being non-invasive, facilitate early diagnosis and mitigation of heart trouble.
- Understanding the discrepancy between a patient's functional and chronological age can offer valuable insights for clinical decision-making.
- This knowledge can foster structured discussions with patients, emphasizing the significance of adopting a healthy lifestyle and managing comorbidities.
- Tracking changes over time allows doctors to adjust treatment plans before permanent damage occurs.
- This new approach could have significant implications for cardiovascular health, mental health, and overall health and wellness.
