Gender-Specific Echocardiographic Findings in Nonagenarians With Cardiovascular Disease

Echocardiographic findings in the fastest growing segment of our population, the very elderly, are limited in the literature. We performed a retrospective analysis of 431 consecutive nonagenarians who underwent transthoracic echocardiography (2-dimensional, M-mode, pulse and continuous wave Doppler with color flow mapping) at our center. Mean age was 92.4 years, with women being the majority (73% vs 27%). Men were more likely than women to have coronary artery disease (45% vs 36%, p = 0.03), impaired left ventricular (LV) ejection fraction (51% vs 40%, p <0.04), lower mean LV ejection fraction (50% vs 54%, p = 0.01), and regional wall motion abnormalities (31% vs 19%, p = 0.009). Women were much more likely than men to have hypertension (76% vs 52%, p = <0.0001), LV hypertrophy (82% vs 72%, p <0.001), severe left atrial enlargement (31% vs 16%, p = 0.004), moderate to severe mitral annular calcification (22% vs 10, p = 0.006), and tricuspid regurgitation (70% vs 51, p = 0.002). In this, largest to date, study of echocardiographic findings in nonagenarians, abnormal findings were much more common than previously reported. Men were more likely to have coronary artery disease and related findings, whereas women were more likely to have hypertension and related findings.