708 PATTERNS OF BIOLOGICAL AGING OF THE HEART AND THEIR PROGNOSTIC VALUE: THE SARDI-NIA STUDY

Abstract

Abstract Background As people age at different rates, the concept of biological age has been introduced as a measure of functional deterioration. Associations of echocardiographic traits with age were analyzed to detect different biological aging rates of the heart and their prognostic value. Methods Echocardiographic left ventricular mass, geometry, left atrial volume, diastolic function, and aortic root size were measured in 3817 adults (58% females). Sex-specific correlations of age with six cardiac traits were assessed in 2614 healthy subjects. According to two-sided 95% tolerance intervals, three patterns of heart aging rates were identified in the whole cohort: slow aging pattern (n=287), normal aging pattern (n=2669), and accelerated aging pattern (n=796). The phenotypic (biological) age of the heart (HeartPhAge) was estimated from the cardiac traits by multiple linear regression. Cardiovascular and non-cardiovascular incident events at follow-up (46 months (IQR 34–64 months) were grouped into three endpoints and analyzed in survival analyses. Results Compared to chronological age, HeartPhAge was nine years younger (p<0.0001) in the slow aging pattern, similar in the normal pattern, and three years older (p<0.0001) in the accelerated pattern. The incidence of all endpoints was higher in the accelerated pattern than in the normal and slow aging patterns (p<0.0001 to p=0.0003). In Cox proportional-hazards analysis, the heart aging patterns significantly predicted all endpoints in both the whole cohort and the healthy subset, independent of chronological age and risk factors. Conclusion Heart aging patterns reflect the rate of biological aging and independently predict cardiovascular and non-cardiovascular events.