Structural and functional changes of the myocardium and heart valves in patients of advanced and senile age with coronary pathology

Abstract

This paper was aimed at studying the structural and functional changes in the myocardium and heart valves in patients of advanced and senile age with coronary pathology. 128 patients with coronary heart disease were examined; the average age was 82.4 ± 10.6 years (from 65 to 90 years old). According to the WHO classification, the patients were divided into two age groups: 1st – elderly people – from 65 to 74 years (32%), 2nd – senile people – from 75 to 90 years (68%). All subjects underwent anamnesis, physical examination, electrocardiography, echocardiography with tissue dopplerography, assessment of global longitudinal strain using a 2D-speckle-tracking technique, coronaroangiography. Patients of elderly and senile age with coronary pathology have age-associated structural and functional myocardial changes, multivessel lesions in the coronary arteries, history of previous myocardial infarction, as well as concomitant pathology (arterial hypertension). The patients older than 75 years have a progression of coronary pathology, systolic and diastolic dysfunction, aortic valve calcification, combined aortic and mitral valve defects, also the number of people with left ventricular hypertrophy is increasing. The number of people with left ventricular hypertrophy is increasing. The study showed informative value of echocardiographic evaluation of global longitudinal myocardial strain to identify the subclinical systolic dysfunction of the myocardium in patients of elderly and senile age with coronary pathology.