Ischaemic left ventricular dysfunction is more frequent at the elderly and has a series of clinical and functional peculiarities. The aim of the paper is to define the clinical, biochemical, and echocardiograph features of the older patients with ischaemic heart disease.
Methods: 189 patients with ischaemic heart disease (old myocardial infarction, angina, ischaemic cardiomiopathy) have been parted, according to age, in Group A (n = 101) over 60 years old and Group B (n = 88) < 60 years old. Symptoms, cardiovascular risk factors, lipid profile, echocardiograph findings, and the exercise testing (at the bicycle) were analyzed.
Results: Ischaemic heart dysfunction appears earlier at the male gender, who is dominant at Group B (83%) in comparison with Group A (48%, p = 0.009). Myocardial infarction is more frequent at Group B (61 vs 42%, p = 0.006), and ischaemic cardiomiopathy at Group A (34% vs. 2%, p = 0.004). At Group A, symptomatic heart failure (dyspnoea of III or IV NYHA class) is prevalent (20% vs. 1%, p = 0.002). Arterial hypertension was dominant at Group A (73% vs. 58%, p = 0.02). At the echocardiograph examination, regional and diffuse contractility abnormalities were dominant at Group A, and the ejection fraction was lower (49 +/- 10%) in comparison to Group B (53 +/- 9%, p = 0.005). Diastolic dysfunction was found in 63% at Group A and 36% at Group B (p = 0.001). At the exercise testing there were not reported significant differences concerning the mechanical load according to age (87% of maximum heart rate at Group A and 83% at Group B).
Conclusions: At the old patients with ischaemic left ventricular dysfunction the presence of a myocardial infarction is not so frequent. Systolic and diastolic dysfunction of the left ventricle is more severe, the ejection fraction is lower, but the exercise capacity did not differ significant.