Cardiac aging phenomenon and its clinical features by echocardiography

Even in healthy subjects, the heart ages along with other organs of the body. A prominent change is progressive left ventricular (LV) diastolic dysfunction, even though LV mass increases slightly during aging. Accordingly, assessment of LV dysfunction can be employed as a surrogate marker of cardiac age. The clinical factors that may accelerate the cardiac aging process include visceral obesity, diabetes mellitus, dyslipidemia, and hypertension. At the molecular level in cardiac myocytes, reactive oxygen species, transforming growth factor-β, mitochondrial function, and lysosomal function are also related to cardiac age. Furthermore, age-related LV dysfunction has been shown to be one of the main risk factors for future heart failure. Consequently, assessment of LV diastolic function is necessary for both preventing cardiac events and assessing cardiac age. Echocardiography provides a noninvasive assessment of cardiac structure and function. This review describes how to assess cardiac aging using echocardiography, and how to interpret the clinical relevance of the findings.