Aging of the heart accelerated by 5 to 45 years due to obesity and unhealthy living habits.
Keeping a close eye on your heart's health can help catch potential issues early and find suitable treatments.
Recently, researchers took a closer look at a method for determining a person's heart's functional age instead of just the biological age. They used cardiac magnetic resonance imaging (MRI) to evaluate heart structure and function in both healthy and unhealthy populations.
The study found that obesity, atrial fibrillation (AFib), and living an unhealthy lifestyle made the heart age faster. Participants with AFib and severe obesity had a greatly increased functional heart age compared to healthy individuals of the same age.
The findings from this research were published in the European Heart Journal Open.
Examining cardiac MRI for heart age calculation
Researchers in this retrospective observational study aimed to explore an effective method for measuring heart aging and the differences between healthy versus unhealthy aging. They highlighted that certain risk factors like high blood pressure can speed up the heart's aging process. One potential tool to assess the heart's physical appearance and function is cardiac magnetic resonance imaging.
The study compared a healthy reference population of 191 participants with a testing population of 366 participants who had at least one comorbidity, such as high blood pressure, diabetes, or obesity. Researchers also used another group of 25 people as a "preliminary external validation" cohort.
Data was gathered from five locations across three countries. Researchers analyzed several components of heart structure and function. They then developed a model to help determine a person's heart age and did further statistical analyses.
Notable differences were observed between the healthy and unhealthy groups. For example, the unhealthy group showed a higher median ejection fraction, which evaluates how much blood the left ventricle pumps out when it contracts.
The final model took left atrial end-systolic volume and left atrial ejection fraction, both of which assess the left upper chamber of the heart's function, into account. These factors were functional parameters significantly connected to age in 169 healthy participants.
Health conditions linked to accelerated heart aging
Researchers found that the heart ages of healthy participants mostly matched their real age. Unhealthy participants usually experienced a higher functional heart age compared to their chronological age. The functional heart ages of these unhealthy participants were nearly five years older than their actual age.
Obesity appeared to increase functional heart age, with more weight leading to an even greater increase in heart years. Participants with a body mass index of 40 or higher had a functional heart age 45 years higher than their chronological age. For participants with AFib, functional heart age was higher than it was for healthy individuals.
Functional heart age was sometimes higher for other comorbidities in certain age groups. In participants between the ages of 30 and 69, participants with high blood pressure had an increased functional heart age compared to healthy participants in the same age range. Similarly, diabetes raised functional heart age for participants aged 30 to 69, with the most significant increase seen in the 40 to 49-year-old group.
However, in the 70 to 85-year-old group, participants with diabetes and high blood pressure actually had lower functional heart ages compared to healthy participants of the same age.
Speaking to MNT, one of the study authors, Pankaj Garg, Dr. Med., noted a few key points.
"We have discovered an equation-a simple math formula-that uses movies from heart MRI scans to figure out how old your heart looks. For healthy folks, their heart age matches their real age. But if someone has conditions like high blood pressure, diabetes, a wonky heartbeat, or extra weight, their heart can look way older-about 4.6 years older on average. For people with a lot of extra weight, their hearts looked up to 45 years older!" - Pankaj Garg, Dr. Med.
Study limitations
Although this research provides promising possibilities for better cardiac health monitoring, it has a few limitations. First, this work included estimations and calculated the functional age of the heart. Second, since the study wasn't long-term, there's a higher risk for survivor bias, which could underestimate the genuine influence comorbidities have on older individuals. Lastly, researchers did not measure how long participants had the measured comorbidities, so there could be variations among unhealthy participants regarding exposure times to these conditions. Additionally, there's noted bias in some calculations, and selection bias was a possibility in this study.
Researchers also acknowledged that there might be variation in the unhealthy group because of medical treatments. They implemented exclusion and inclusion criteria, which may have limited the study population. The development of the age calculation model required making several decisions, and researchers may find areas for further refinement.
Patrick Kee, Dr. Med., a cardiologist who was not involved in the study, noted several potential limitations, such as the study's inability to examine long-term data, lack of other measurements that could have been beneficial, and reliance on a simple model that only focused on left atrium end-diastolic volume and left atrium ejection fraction.
Long-term studies will likely be advantageous, as well as finding out if changing factors like lifestyle can alter outcomes.
"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 unclear whether lifestyle and therapeutic interventions will alter the trajectory of the heart age due to underlying medical conditions," Kee noted.
Test could aid early detection, encourage heart-healthy actions
Cheng-Han Chen, Dr. Med., a board-certified interventional cardiologist and medical director of the Structural Heart Program at MemorialCare Saddleback Medical Center, who was not involved in the study, also pointed out that determining the functional age of the heart could be a helpful preventive measure.
"An assessment of a 'functional heart age' (either through imaging or other biomarkers) can potentially motivate patients to improve their lifestyles, identify patients at risk for future clinical events, and possibly even evaluate response to clinical therapeutics and interventions."- Cheng-Han Chen, Dr. Med.
Using cardiac MRI also has appeal because of its ease of use and the fact that only a few minutes are needed for the test. This makes it a potential tool for quickly evaluating large numbers of people, which may help catch heart trouble early before more serious issues, like heart failure, arise.
Lastly, there could also be potential improvements in communication between doctors and those at risk for heart problems, as this method could help individuals better understand the necessity of making changes to their lifestyle for better heart health.
"By comparing a patient's 'functioning heart age' with their 'chronological age,' clinicians can effectively communicate 'cardiovascular risk' to encourage lifestyle and therapeutic modifications. This approach can also serve as a tangible measure to motivate patients toward preventive strategies such as weight management, blood pressure control, and diabetes management to mitigate the progressive decline in heart health. Tracking changes over time allows clinicians to adjust treatment plans before irreversible damage occurs."- Patrick Kee, Dr. Med.
- The European Heart Journal Open published the findings of a study that used cardiac magnetic resonance imaging (MRI) to evaluate the heart's structure and function in both healthy and unhealthy populations.
- Obesity, atrial fibrillation (AFib), and an unhealthy lifestyle were found to speed up the heart's aging process.
- Participants with AFib and severe obesity had a significantly greater increase in functional heart age compared to healthy individuals of the same age.
- The study found that obesity often increased functional heart age, with more weight leading to an even greater increase in heart years.
- For participants with a body mass index (BMI) of 40 or higher, functional heart age was 45 years higher than their chronological age.
- The final model developed by the researchers took left atrial end-systolic volume and left atrial ejection fraction into account for determining a person's heart age.
- Healthy participants mostly had hearts that matched their real age, while unhealthy participants typically had higher functional heart ages compared to their chronological age.
- Functional heart age was sometimes higher for participants with high blood pressure, diabetes, or other comorbidities in certain age groups.
- Determining the functional age of the heart could be a helpful preventive measure, potentially motivating patients to make lifestyle changes, and encouraging communication between doctors and patients about heart health.
