Clinical, Electrocardiographic, and Echocardiographic Features in Hospitalized Nonagenarians (90+): Comparison between the Genders

<b><i>Objectives:</i></b> We investigated the clinical, electrocardiographic, and echocardiographic determinants of the cardiac status in nonagenarian patients. <b><i>Methods:</i></b> We consecutively examined 654 Caucasian patients (232 males and 422 females) aged ≥90 years. All patients underwent clinical examination, ECG, and transthoracic echocardiography. <b><i>Results:</i></b> Their average age was 92.5 ± 2.5 years. Patients were predominately female of older age (<i>p</i> < 0.0001 and <i>p</i> = 0.02, respectively). A history of cardiovascular disease was present in 78.4% of the participants. One third of the patients was hospitalized for cardiovascular causes, with females being twice as many (<i>p</i> < 0.0001). Females showed higher levels of serum cholesterol, triglycerides, and glycemia (<i>p</i> < 0.0001, <i>p</i>< 0.0001, and <i>p</i> = 0.04 respectively). Sinus rhythm was detected in 65%, and atrial fibrillation in 31% of the overall population. Heart rate, PR and corrected QT (QTc) intervals, right bundle branch block (RBBB) and RBBB associated with left anterior fascicular block (LAFB) were higher in males (<i>p</i> < 0.0001, <i>p</i> = 0.036, <i>p</i> = 0.009, <i>p</i> = 0.001, and <i>p</i> = 0.004, respectively). Aortic root dimension, left ventricular (LV) mass index, and indexed LV systolic-diastolic volumes were higher in males (<i>p</i> < 0.001, <i>p</i> < 0.0001, <i>p</i> < 0.001, and <i>p</i> < 0.0001, respectively). Women showed fewer LV segmental kinetic disorders (<i>p</i> = 0009) and higher LV ejection fraction (LVEF; <i>p</i>< 0.0001). Hyperuricemia was positively associated with a history of cardiovascular disease (<i>r</i> = 0.15), glycemia (<i>r</i> = 19), creatininemia (<i>r</i> = 0.50), uremia (<i>r</i> = 0.51), triglycerides (<i>r</i> = 0.19), PR interval (<i>r</i> = 0.14), and left bundle branch block (<i>r</i> = 0.11), and inversely associated with sinus rhythm (r = –0.14) and LVEF (<i>r</i> = –0.17). Diabetes was positively correlated with PR and QTc intervals (<i>r</i> = 0.14 and <i>r</i> = 0.10, respectively), and RBBB with LFAB (<i>r</i> = 0.10), and inversely correlated with LVEF (<i>r</i> = –0.10). <b><i>Conclusions:</i></b> We found a remarkable presence of cardiovascular risk factors, ECG, and structural alterations in hospitalized nonagenarians, which presents more commonly in males.

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