Lifestyle choices and obesity can accelerate heart aging by 5-45 years
Revised Article:
Peering into the Heart's True Age: Using MRI to Uncover Early Signs of Heart Issues
Delving into the heart's health and detecting shifts over time is crucial for catching heart troubles early and implementing helpful interventions.
In an intriguing study, researchers proposed a method to calculate the functional age of people's hearts compared to their biological age. Here's how they did it.
Researchers investigated ways to gauge the heart's age and the changes that take place during healthy and unhealthy aging. They noted that several modifiable risk factors, such as elevated blood pressure, accelerate heart aging. Cardiac magnetic resonance imaging (MRI) is one potential tool to observe the heart's appearance and function in action.
The study cohort comprised a reference group of 191 healthy participants and a test group of 366 individuals with at least one comorbidity, like high blood pressure, diabetes, or obesity. The researchers also employed another group of 25 subjects as a preliminary external validation cohort. The participants originated from five distinct locations across three countries.
By analyzing several heart structure and function aspects, researchers developed a model to help determine the age of participants' hearts. Using statistical analyses, they discovered significant differences between healthy and unhealthy groups. For instance, the unhealthy group demonstrated a higher median ejection fraction, which gauges the amount of blood the left ventricle pumps out with each contraction.
The final model the researchers constructed considered the left atrial end-systolic volume and left atrial ejection fraction, both of which appraise the left upper chamber of the heart's function. These parameters were functional factors significantly associated with age for 169 healthy participants.
Health Conditions that Expedite Heart Aging
Researchers found that in healthy participants, their hearts' ages mirrored their real ages. On the other hand, unhealthy participants saw their heart ages exceed their chronological age. Their cardiac MRI-derived heart ages were over four years older than the chronological age of these participants.
Obesity seemed to expand functional heart age. More weight translated to more heart years. Participants with a body mass index (BMI) of 40 or higher had a functional heart age 45 years greater than their chronological age. For participants with atrial fibrillation, heart functional age was also higher than for healthy participants.
Functional heart age could sometimes be higher for other comorbidities in specific age groups. Among participants ranging from 30 to 69 years old, those with high blood pressure had increased functional heart age compared to healthy participants in the same age bracket.
A similarly noticeable increase in functional heart age for diabetes was observed across participants between 30 and 69, with the most significant increase seen among the 40 to 49-year-old group. However, in those aged 70 to 85, individuals with both diabetes and high blood pressure had lower functional heart ages than healthy peers of the same age.
Dr. Pankaj Garg, the study's co-author and Associate Professor in Cardiovascular Medicine at the University of East Anglia, emphasized some key findings:
"We have unearthed a simple, math-based formula using heart MRI scans to ascertain the heart's age. For healthy people, their heart age syncs with their real age. But for those with health hiccups like high blood pressure, diabetes, an irregular heartbeat, or extra pounds, their hearts often seem older- about 4.6 years older on average. For those with significant weight, their hearts can appear up to 45 years older!”
Study Limitations
While this research presents a promising prospect for enhanced cardiac health monitoring, it also bears some constraints. First, this work focuses on estimations and estimates the functional age of the heart. Second, being a non-long-term study, it carries a higher risk of survivor bias which may downplay the impact of comorbidities on the elderly. Thirdly, researchers did not account for how long participants had experienced the measured comorbidities. Bias is observed in some calculations. Researchers also acknowledged the possibility of selection bias. This study did not evaluate certain factors like exercise and diet, among others.
The researchers also considered variations in the unhealthy group due to medical treatments.
Researchers had exclusion and inclusion criteria, which influenced who could take part in the study. For example, they omitted individuals with severe chronic kidney disease, as this is an MRI scan contraindication. The development of the age calculation model entailed making numerous decisions, and researchers may identify areas for refinement.
Dr. Patrick Kee, MD, PhD, a cardiologist at Vital Heart & Vein who was not involved in the study, highlighted several potential limitations, including its incapacity to examine long-term data, lack of additional measurements that could have been beneficial, and the use of a simple model that concentrated on the left atrium end-diastolic volume and left atrium ejection fraction.
Long-term studies are likely to be beneficial, as well as observing how factors like lifestyle could influence outcomes.
"The model was provisionally validated on a limited 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.
Potential Benefits of Heart Age Assessment
Dr. Cheng-Han Chen, a board-certified interventional cardiologist and the medical director of the Structural Heart Program at MemorialCare Saddleback Medical Center in Laguna Hills, CA, not involved in the study, underlined that determining the functional age of the heart might offer crucial preventive measures.
"Assessing the 'functional heart age' (either through imaging or other biomarkers) can potentially motivate patients to enhance their lifestyles, pinpoint patients at risk for future clinical events, and perhaps even assess response to clinical therapeutics and interventions."- Dr. Cheng-Han Chen
Leveraging heart MRI presents an appeal due to the simplicity of its use.
"Heart MRI scans are entirely non-invasive tests-meaning zero cuts or needles-and for checking the heart age, only a few minutes of this test are necessary. If required, this can be carried out in a concise manner to help countless individuals swiftly. This could help detect heart trouble early and forestall bigger problems, like heart failure, later on," Garg explained.
Finally, there's the potential for improved communication between doctors and people at risk for heart problems. Researchers mentioned that it could help people comprehend the need for change.
"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."- Dr. Patrick Kee, MD, PhD
Insight Enrichment
Cardiac magnetic resonance imaging (MRI) offers a detailed, comprehensive evaluation of the heart's structure and function, enabling the comparison of these measurements to an individual's biological (chronological) age, revealing the "functional age" of the heart. This assessment reflects how well the heart functions and the degree of age-related remodeling it exhibits, rather than a person's actual age.
Researchers calculate functional heart age by examining various heart parameters, including chamber volumes and pumping efficiency, via cardiac MRI. Formulas or models based on MRI data help doctors see if an individual's heart is aging faster or slower than expected for their biological age.
Functional heart age is essentially how old the heart "acts," signifying the physiological wear and remodeling that occur with age and disease. In healthy individuals, heart functional age is usually close to their chronological age, indicating normal aging processes. However, in those with certain health conditions, their functional heart age may be significantly older than their actual age, sometimes by decades. This indicates that the heart is aging prematurely or under accelerated stress.
Conditions like diabetes, hypertension, obesity, and atrial fibrillation have been demonstrated to contribute to increased functional heart age as revealed by cardiac MRI. Other unhealthy lifestyle factors such as chronic stress, poor diet, and physical inactivity also accelerate heart aging and can be identified through MRI-based assessment.
Knowing a patient’s heart functional age provides doctors with an early warning system, allowing them to intervene before overt symptoms of heart disease develop. This knowledge can lead to targeted lifestyle advice and treatments aimed at lowering blood pressure, controlling glucose, encouraging regular exercise, managing weight, and improving overall cardiovascular health. Cardiac MRI is considered the gold standard for this assessment as it is radiation-free and highly accurate in quantifying heart structure and function.
- The study revealed that obesity expands functional heart age, with each additional weight translating to more heart years.
- Seniors with at least one comorbidity, such as high blood pressure, diabetes, or obesity, showed a significant increase in their heart functional age compared to healthy peers.
- Researchers discovered that participants with a body mass index (BMI) of 40 or higher had a functional heart age 45 years greater than their chronological age.
- Among participants between 30 and 69, those with high blood pressure had increased functional heart age compared to healthy participants in the same age bracket.
- Similarly, a notable increase in functional heart age for diabetes was observed across participants between 30 and 69, with the most significant increase seen among the 40 to 49-year-old group.
- In those aged 70 to 85, individuals with both diabetes and high blood pressure had lower functional heart ages than healthy peers of the same age.
- Determining the functional age of the heart might offer crucial preventive measures, as it could potentially motivate patients to enhance their lifestyles and assess response to clinical therapeutics and interventions (Dr. Cheng-Han Chen).
- Heart age assessment could help people comprehend the need for change, allowing clinicians to adjust treatment plans before irreversible damage occurs (Dr. Patrick Kee, MD, PhD).
- Heart MRI scans are simpler to use, being completely non-invasive tests that require only a few minutes (Dr. Pankaj Garg).
- By employing MRI-based assessment, doctors may identify unhealthy lifestyle factors like chronic stress, poor diet, and physical inactivity that accelerate heart aging.
