In a recent poll we asked two questions regarding age-related changes of cardiac biomarkers and echocardiographic parameters. The first question addressed the natural history of echocardiographic changes with aging.

The results shown above indicate that most responders selected "reduction in left ventricular ejection fraction" (67%), which is the correct answer. While normal aging is associated with concentric left ventricular remodeling, impaired relaxation, decrease in left ventricular volume, and impairment in longitudinal systolic function as assessed by strain imaging, resting left ventricular ejection fraction is not affected by increasing age.

The second question focused on age-related physiological changes in commonly used cardiovascular biomarkers (cTn and NT-proBNP).

The poll found that almost half of responders selected "increase in NT-proBNP and no change in cTn" (47%). The most commonly used biomarkers for cardiovascular diagnosis are cardiac troponin for diagnosis of myocardial infarction and the natriuretic peptides for the diagnosis of heart failure. Plasma levels of these biomarkers usually increase with aging due to several factors, such as declining renal function, changes in body composition and hormonal changes in addition to presence and severity of clinical or subclinical disease. Only 21.5% chose "increase in cTn and increase in NT-proBNP", which is the correct answer. Notably, an almost equal number of respondents selected "no change in cTn or NT-proBNP". These findings suggest a need for increased education about the association of age with biomarker levels to ensure accurate interpretation of these commonly used tests.

For further information on this topic please see Cardiovascular Biomarkers and Imaging in Older Adults, and the article Forman DE, de Lemos JA, Shaw LJ, et al. Cardiovascular biomarkers, and imaging in older adults: JACC Council Perspectives. J Am Coll Cardiol 2020; 76:1577-94.

Clinical Topics: Anticoagulation Management, Geriatric Cardiology, Heart Failure and Cardiomyopathies, Noninvasive Imaging, Acute Heart Failure, Heart Failure and Cardiac Biomarkers, Echocardiography/Ultrasound

Keywords: Geriatrics, Stroke Volume, Ventricular Remodeling, Ventricular Function, Left, Natriuretic Peptide, Brain, Heart Failure, Natriuretic Peptides, Peptide Fragments, Echocardiography, Myocardial Infarction, Biomarkers, Body Composition, Plasma, Troponin

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