Asociación entre fragilidad y hallazgos ecocardiográficos en personas mayores hospitalizadas en dos centros de referencia en la ciudad de Manizales
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- Tipo de recurso:
- Fecha de publicación:
- 2025
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- Universidad de Caldas
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- Repositorio Institucional U. Caldas
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- spa
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- 610 - Medicina y salud
3. Ciencias Médicas y de la Salud
Fragilidad
Disfunción diastólica
Persona mayor
Fracción eyección preservada
Ecocardiografía
Gerontología
Medicina
Anciano
Envejecimiento
Vejez
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Asociación entre fragilidad y hallazgos ecocardiográficos en personas mayores hospitalizadas en dos centros de referencia en la ciudad de Manizales |
| title |
Asociación entre fragilidad y hallazgos ecocardiográficos en personas mayores hospitalizadas en dos centros de referencia en la ciudad de Manizales |
| spellingShingle |
Asociación entre fragilidad y hallazgos ecocardiográficos en personas mayores hospitalizadas en dos centros de referencia en la ciudad de Manizales 610 - Medicina y salud 3. Ciencias Médicas y de la Salud Fragilidad Disfunción diastólica Persona mayor Fracción eyección preservada Ecocardiografía Gerontología Medicina Anciano Envejecimiento Vejez |
| title_short |
Asociación entre fragilidad y hallazgos ecocardiográficos en personas mayores hospitalizadas en dos centros de referencia en la ciudad de Manizales |
| title_full |
Asociación entre fragilidad y hallazgos ecocardiográficos en personas mayores hospitalizadas en dos centros de referencia en la ciudad de Manizales |
| title_fullStr |
Asociación entre fragilidad y hallazgos ecocardiográficos en personas mayores hospitalizadas en dos centros de referencia en la ciudad de Manizales |
| title_full_unstemmed |
Asociación entre fragilidad y hallazgos ecocardiográficos en personas mayores hospitalizadas en dos centros de referencia en la ciudad de Manizales |
| title_sort |
Asociación entre fragilidad y hallazgos ecocardiográficos en personas mayores hospitalizadas en dos centros de referencia en la ciudad de Manizales |
| dc.contributor.none.fl_str_mv |
Zuluaga Rojas, Jose Fernando Arango Gómez, Fernando Murillo Molina, Tatiana Hincapié Córdoba, Daniel Alberto Morales, Diana Carolina BENJUMEA SALGADO, ANGELA MARIA |
| dc.subject.none.fl_str_mv |
610 - Medicina y salud 3. Ciencias Médicas y de la Salud Fragilidad Disfunción diastólica Persona mayor Fracción eyección preservada Ecocardiografía Gerontología Medicina Anciano Envejecimiento Vejez |
| topic |
610 - Medicina y salud 3. Ciencias Médicas y de la Salud Fragilidad Disfunción diastólica Persona mayor Fracción eyección preservada Ecocardiografía Gerontología Medicina Anciano Envejecimiento Vejez |
| description |
tablas, figuras |
| publishDate |
2025 |
| dc.date.none.fl_str_mv |
2025-02-17T16:54:10Z 2025-02-17T16:54:10Z 2025-02-15 |
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Trabajo de grado - Especialización http://purl.org/coar/resource_type/c_18ws Text info:eu-repo/semantics/report |
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http://purl.org/coar/resource_type/c_93fc |
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https://repositorio.ucaldas.edu.co/handle/ucaldas/22009 Universidad de Caldas Repositorio Institucional Universidad de Caldas repositorio.ucaldas.edu.co |
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https://repositorio.ucaldas.edu.co/handle/ucaldas/22009 |
| identifier_str_mv |
Universidad de Caldas Repositorio Institucional Universidad de Caldas repositorio.ucaldas.edu.co |
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spa |
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Naciones Unidas. Desarrollo en un mundo que envejece [Internet]. 2007. 1–22 p. Disponible en: https://fiapam.org/wp-content/uploads/2013/06/El-desarrollo-en-unmundo-que-envejece.pdf. Dávila-Cervantes CA, Pardo-Montaño AM. Cambios en la esperanza de vida por causas de muertes crónicas en adultos mayores. México 2000-2013. Revista Ciencias de la Salud. 2017;15(2):223–35 Fried LP, Tangen CM, Walston J, Newman AB, Hirsch C, Gottdiener J, et al. Frailty in Older Adults: Evidence for a Phenotype [Internet]. Vol. 56, Journal of Gerontology: MEDICAL SCIENCES Copyright. 2001. Available from: https://academic.oup.com/biomedgerontology/article-abstract/56/3/M146/545770 Abdulla A. Damluji. Frailty and cardiovascular outcomes in the National Health and Aging Trends Study. Vol. 42, European Heart Journal. Oxford University Press; 2021. p. 3866– 8 Morley JE, Vellas B, Abellan van Kan G, Anker SD, Bauer JM, Bernabei R, et al. Frailty consensus: A call to action. 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Sci Rep. 2021 Dec 1;11(1) Kane AE, Bisset ES, Heinze-Milne S, Keller KM, Grandy SA, Howlett SE. Maladaptive changes associated with cardiac aging are sex-specific and graded by frailty and inflammation in C57BL/6 Mice. Journals of Gerontology - Series A Biological Sciences and Medical Sciences. 2021 Feb 1;76(2):233–43 Gharacholou SM, Tashiro T, Cha SS, Scott CG, Takahashi PY, Pellikka PA. Echocardiographic Indices Associated with Frailty in Adults ≥65 Years. American Journal of Cardiology. 2015 Nov 15;116(10):1591–5 Hwang AC, Liu LK, Lee WJ, Chen LY, Peng LN, Lin MH, et al. Association of frailty and cardiometabolic risk among community-dwelling middle-aged and older people: Results from the I-Lan longitudinal aging study. Rejuvenation Res. 2015 Dec 1;18(6):564–72. Nadruz W, Kitzman D, Windham BG, Kucharska-Newton A, Butler K, Palta P, et al. Cardiovascular Dysfunction and Frailty among Older Adults in the Community: The ARIC Study. Journals of Gerontology - Series A Biological Sciences and Medical Sciences. 2017 Jul 1;72(7):958–64. Frisoli A, Ingham SJMN, Paes ÂT, Tinoco E, Greco A, Zanata N, et al. Frailty predictors and outcomes among older patients with cardiovascular disease: Data from Fragicor. Arch Gerontol Geriatr. 2015 Jul 1;61(1):1–7 United Nations. World economic and social survey, 2007: development in an ageing world. Choice Reviews Online. 2007. p.212. Disponible en: https://www.un.org/en/development/desa/policy/wess/wess_archive/2007wess.pdf. UNO; 2007. Kojima G, Iliffe S. Epidemiology of Frailty. In: Encyclopedia of Gerontology and Population Aging. Springer International Publishing; 2019. p. 1–7. Chen MA. Frailty and cardiovascular disease: Potential role of gait speed in surgical risk stratification in older adults. Vol. 12, Journal of Geriatric Cardiology. Science Press; 2015. p. 44–56 Lemus Barrios GA, Morales Benavidez DC, López Salazar AM, Henao V, GonzálezRobledo G. Assessment of frailty in cardiovascular disease: A necessary challenge. Vol. 27, Revista Colombiana de Cardiologia. Elsevier B.V.; 2020. p. 283–93. Hoogendijk EO, Afilalo J, Ensrud KE, Kowal P, Onder G, Fried LP. Frailty: implications for clinical practice and public health [Internet]. Vol. 394, www.thelancet.com. 2019. Available from: www.thelancet.com Ocampo-Chaparro JM, Reyes-Ortiz CA, Castro-Flórez X, Gómez F. Frailty in older adults and their association with social determinants of health. the SABE Colombia study. Colomb Med. 2019;50(2):89–101. Clegg A, Young J, Iliffe S, Rikkert MO, Rockwood K. Frailty in elderly people. In: The Lancet. Elsevier B.V.; 2013. p. 752–62 Stewart R. Cardiovascular disease and frailty: What are the mechanistic links? Clin Chem. 2019 Jan 1;65(1):80–6 Afilalo J, Alexander KP, Mack MJ, Maurer MS, Green P, Allen LA, et al. Frailty assessment in the cardiovascular care of older adults. Vol. 63, Journal of the American College of Cardiology. Elsevier USA; 2014. p. 747–62 Buta BJ, Walston JD, Godino JG, Park M, Kalyani RR, Xue QL, et al. Frailty assessment instruments: Systematic characterization of the uses and contexts of highly-cited instruments. Vol. 26, Ageing Research Reviews. Elsevier Ireland Ltd; 2016. p. 53–61. Singh M, Stewart R, White H. Importance of frailty in patients with cardiovascular disease. Vol. 35, European Heart Journal. 2014 Chen MA. Frailty and cardiovascular disease: Potential role of gait speed in surgical risk stratification in older adults. Vol. 12, Journal of Geriatric Cardiology. Science Press; 2015. p. 44–56 Gary R. Evaluation of frailty in older adults with cardiovascular disease: Incorporating physical performance measures. Journal of Cardiovascular Nursing. 2012 Mar;27(2):120– 31. Sunaga A, Hikoso S, Yamada T, Yasumura Y, Uematsu M, Tamaki S, et al. Prognostic impact of Clinical Frailty Scale in patients with heart failure with preserved ejection fraction. ESC Heart Fail. 2021 Aug 1;8(4):3316–26. Lang RM, Badano LP, Mor-Avi V, Afilalo J, Armstrong A, Ernande L, et al. Recomendaciones para la Cuantificación de las Cavidades Cardíacas por Ecocardiografía en Adultos: Actualización de la Sociedad Americana de Ecocardiografía y de la Asociación Europea de Imagen Cardiovascular Halvorsen S, Mehilli J, Cassese S, Hall TS, Abdelhamid M, Barbato E, et al. 2022 ESC Guidelines on cardiovascular assessment and management of patients undergoing noncardiac surgery. Vol. 43, European Heart Journal. Oxford University Press; 2022. p. 3826–924. Gharacholou SM, Tashiro T, Cha SS, Scott CG, Takahashi PY, Pellikka PA. Echocardiographic Indices Associated with Frailty in Adults ≥65 Years. American Journal of Cardiology. 2015 Nov 15;116(10):1591–5. Sison SDM, Shi SM, Kim KM, Steinberg N, Jeong S, McCarthy EP, et al. A crosswalk of commonly used frailty scales. J Am Geriatr Soc. 2023 Oct 1;71(10):3189–98. Searle SD, Mitnitski A, Gahbauer EA, Gill TM, Rockwood K. A standard procedure for creating a frailty index. BMC Geriatr. 2008;8 Zhang H, Hao M, Hu Z, Li Y, Hu X, Jiang X, et al. Causal Association of Cardiac Function by Magnetic Resonance Imaging with Frailty Index: A Mendelian Randomization Study. Phenomics. 2022 Dec 1;2(6):430–7 Pavasini R, Cardelli LS, Piredda A, Tonet E, Campana R, Vitali F, et al. Diastolic dysfunction, frailty and prognosis in elderly patients with acute coronary syndromes. Int J Cardiol. 2021 Mar 15;327:31–5. Rose RA, Howlett SE. Preclinical Studies on the Effects of Frailty in the Aging Heart. Vol. 40, Canadian Journal of Cardiology. Elsevier Inc.; 2024. p. 1379–93 Zhang Y, Safar ME, Iaria P, Agnoletti D, Protogerou AD, Blacher J. Prevalence and prognosis of left ventricular diastolic dysfunction in the elderly: The PROTEGER Study. Am Heart J. 2010;160(3):471–8 Kusunose K, Okushi Y, Yamada H, Nishio S, Torii Y, Hirata Y, et al. Prognostic value of frailty and diastolic dysfunction in elderly patients. Circulation Journal. 2018;82(8):2103– 10 Van Gelder IC, Rienstra M, Bunting K V, Casado-Arroyo R, Caso V, Crijns HJGM, et al. 2024 ESC Guidelines for the management of atrial fibrillation developed in collaboration with the European Association for Cardio-Thoracic Surgery (EACTS). Eur Heart J [Internet]. 2024 Sep 29;45(36):3314–414. Available from: https://academic.oup.com/eurheartj/article/45/36/3314/7738779 Deniz A, Ozmen C, Bayram E, Seydaoglu G, Usal A. Frailty significantly impairs the short term prognosis in elderly patients with heart failure. Journal of Geriatric Cardiology. 2018;15(11):675–81. Kim MK, Kim B, Lee JY, Kim JS, Han BG, Choi SO, et al. Tissue Doppler-derived E/e′ ratio as a parameter for assessing diastolic heart failure and as a predictor of mortality in patients with chronic kidney disease. 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Tan MP. Healthcare for older people in lower and middle income countries. Vol. 51, Age and Ageing. Oxford University Press; 2022. United Nations. Leaving No One Behind In An Ageing World.[Internet]. 2023. 1–20 p. Disponible en: https://desapublications.un.org/publications/world-social-report-2023- leaving-no-one-behind-ageing-world. Szanton SL, Seplaki CL, Thorpe RJ, Allen JK, Fried LP. Socioeconomic status is associated with frailty: The Women’s Health and Aging Studies. J Epidemiol Community Health (1978). 2010 Jan;64(1):63–7 Wang J, Hulme C. Frailty and socioeconomic status: A systematic review. Vol. 10, Journal of Public Health Research. 2021 Castañeda H. Fragilidad y características clínicas en pacientes muy ancianos con falla cardiaca aguda. 2022. Damluji AA, Alfaraidhy M, AlHajri N, Rohant NN, Kumar M, Al Malouf C, et al. Sarcopenia and Cardiovascular Diseases. Vol. 147, Circulation. Lippincott Williams and Wilkins; 2023. p. 1534–53 Wijnant SRA, Benz E, Luik AI, Rivadeneira F, Voortman T, Brusselle GG, et al. Frailty Transitions in Older Persons With Lung Function Impairment: A Population-Based Study. Journals of Gerontology - Series A Biological Sciences and Medical Sciences. 2023 Feb 1;78(2):349–56. Wang L, Zhang X, Liu X. Prevalence and clinical impact of frailty in COPD: a systematic review and meta-analysis. BMC Pulm Med. 2023 Dec 1;23(1). Lahousse L, Ziere G, Verlinden VJA, Zillikens MC, Uitterlinden AG, Rivadeneira F, et al. Risk of Frailty in Elderly With COPD: A Population-Based Study. Journals of Gerontology - Series A Biological Sciences and Medical Sciences. 2016 May 1;71(5):689–95 Talha KM, Pandey A, Fudim M, Butler J, Anker SD, Khan MS. Frailty and heart failure: State-of-the-art review. Vol. 14, Journal of Cachexia, Sarcopenia and Muscle. John Wiley and Sons Inc; 2023. p. 1959–72. |
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Universidad de Caldas Facultad de Ciencias para la Salud Manizales Especialización Medicina Interna - Geriatría |
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Universidad de Caldas Facultad de Ciencias para la Salud Manizales Especialización Medicina Interna - Geriatría |
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Asociación entre fragilidad y hallazgos ecocardiográficos en personas mayores hospitalizadas en dos centros de referencia en la ciudad de Manizales610 - Medicina y salud3. Ciencias Médicas y de la SaludFragilidadDisfunción diastólicaPersona mayorFracción eyección preservadaEcocardiografíaGerontologíaMedicinaAncianoEnvejecimientoVejeztablas, figurasObjetivo: Este estudio tiene como objetivo establecer la asociación entre la fragilidad, la estructura y la función cardíaca en personas mayores hospitalizadas con fracción de eyección preservada, utilizando parámetros ecocardiográficos y el índice de fragilidad de Fried. Métodos: Se llevó a cabo un estudio transversal con alcance analítico en dos centros de referencia. Se incluyó a 269 personas mayores de 60 años o más, excluyendo condiciones que afectan la mecánica ventricular. Los pacientes se dividieron en grupos no frágiles, pre- frágiles y frágiles. La ecocardiografía transtorácica incluyó imágenes 2D, Doppler y Strain Longitudinal Global del ventrículo izquierdo. El análisis comparativo se consideró estadísticamente significativo si p < 0,05. Resultados: La fragilidad se asoció significativamente con la disfunción diastólica, con un Odds Ratio ajustado de 3.38 (IC del 95%: 1.82-6.30; p = 0.000). La estructura cardíaca del grupo frágil mostró diferencias en comparación con los pacientes no frágiles; el grupo frágil tuvo volúmenes auriculares mayores y volúmenes ventriculares menores. La presión sistólica de la arteria pulmonar y la velocidad de regurgitación tricuspídea fueron significativamente mayores en los pacientes frágiles, sin diferencias en el Strain Longitudinal Global del ventrículo izquierdo. Conclusión: La fragilidad es un factor de riesgo independiente para la disfunción diastólica. En personas mayores hospitalizadas, se observa que está asociada a cambios estructurales y funcionales cardíacos significativos.Objective: This study aims to establish the association between frailty and cardiac structure and function in hospitalized elderly patients with preserved ejection fraction, using echocardiographic parameters and the Fried frailty index. Methods: A cross-sectional study with an analytical approach was conducted in two reference centers. A total of 269 elderly patients aged 60 years or older were included, excluding conditions affecting ventricular mechanics. Patients were divided into non-frail, pre-frail, and frail groups. Transthoracic echocardiography included 2D images, Doppler, and Global Longitudinal Strain of the left ventricle. Comparative analysis was considered statistically significant if p < 0.05. Results: Frailty was significantly associated with diastolic dysfunction, with an adjusted Odds Ratio of 3.38 (95% CI: 1.82-6.30; p = 0.000). The cardiac structure of the frail group showed differences compared to non-frail patients; the frail group had larger atrial volumes and smaller ventricular volumes. Systolic pressure of the pulmonary artery and tricuspid regurgitation velocity were significantly elevated in frail patients, with no observed differences in the Global Longitudinal Strain of the left ventricle. Conclusion: Frailty is an independent risk factor for diastolic dysfunction. In hospitalized elderly patients, it is associated with significant structural and functional cardiac changes.Resumen / Abstract / Introducción / Planteamiento del problema / Justificación / Pregunta de investigación / Objetivos / Metodología / Resultados / Variables demográficas, antropométricas y clínicas / Características de los pacientes no frágiles, pre-frágiles y frágiles / Parámetros ecocardiográficos estructurales / Parámetros ecocardiográficos funcionales / Modelo de regresión logística / Discusión / Parámetros Estructurales / Parámetros Funcionales / Proporción de pacientes clasificados como frágiles y pre-frágiles / Características clínicas y antropométricas / Características demográficas / Comparación entre población frágil, pre-frágil y no frágil / Fortalezas / Limitaciones / Conclusiones / Anexos / Anexo 1: Instrumento de selección de participantes / Anexo 2: Consentimiento informado / Anexo 3: Instrumento de valoración / Anexo 4: Tabla operacionalización de variables / Referencias bibliográficasEspecializaciónTipo de investigación: Cuantitativo. Nivel de investigación: Relacional. Diseño del estudio: Correlacional transversal con alcance analítico. Población: Personas hospitalizadas de 60 años o más, a quienes se les haya realizado un ecocardiograma transtorácico durante su estancia en el Hospital Departamental Universitario Santa Sofía de Caldas o S.E.S Hospital Universitario de Caldas. Muestra: Se calculó basado en los resultados encontrados en estudios previos (7,31). El tamaño de la muestra se consideró con un nivel de significancia del 95% y poder del 80%, para una muestra de 176 sujetos. Teniendo en cuenta que la prevalencia de personas mayores clasificadas como prefrágiles es del 47% (7), se adicionó dicha proporción al tamaño de muestra. Para un total de 260 pacientes.Especialista Medicina Interna - GeriatríaUniversidad de CaldasFacultad de Ciencias para la SaludManizalesEspecialización Medicina Interna - GeriatríaZuluaga Rojas, Jose FernandoArango Gómez, FernandoMurillo Molina, TatianaHincapié Córdoba, Daniel AlbertoMorales, Diana CarolinaBENJUMEA SALGADO, ANGELA MARIABetancourt Zuluaga, Daniel2025-02-17T16:54:10Z2025-02-17T16:54:10Z2025-02-15Trabajo de grado - Especializaciónhttp://purl.org/coar/resource_type/c_18wsTextinfo:eu-repo/semantics/reporthttp://purl.org/coar/resource_type/c_93fc58 páginasapplication/pdfapplication/pdfapplication/pdfapplication/pdfhttps://repositorio.ucaldas.edu.co/handle/ucaldas/22009Universidad de CaldasRepositorio Institucional Universidad de Caldasrepositorio.ucaldas.edu.cospaNaciones Unidas. Desarrollo en un mundo que envejece [Internet]. 2007. 1–22 p. Disponible en: https://fiapam.org/wp-content/uploads/2013/06/El-desarrollo-en-unmundo-que-envejece.pdf.Dávila-Cervantes CA, Pardo-Montaño AM. Cambios en la esperanza de vida por causas de muertes crónicas en adultos mayores. México 2000-2013. Revista Ciencias de la Salud. 2017;15(2):223–35Fried LP, Tangen CM, Walston J, Newman AB, Hirsch C, Gottdiener J, et al. Frailty in Older Adults: Evidence for a Phenotype [Internet]. Vol. 56, Journal of Gerontology: MEDICAL SCIENCES Copyright. 2001. Available from: https://academic.oup.com/biomedgerontology/article-abstract/56/3/M146/545770Abdulla A. Damluji. Frailty and cardiovascular outcomes in the National Health and Aging Trends Study. Vol. 42, European Heart Journal. Oxford University Press; 2021. p. 3866– 8Morley JE, Vellas B, Abellan van Kan G, Anker SD, Bauer JM, Bernabei R, et al. Frailty consensus: A call to action. J Am Med Dir Assoc. 2013;14(6):392–7Lemus Barrios GA, Cárdenas Castellanos JM, Curcio Borrero CL, Moreno Gómez GA. Effects of frailty on the adverse outcomes of cardiac surgery in the elderly. Revista Colombiana de Cardiologia. 2020 Jul 1;27(4):250–61.Xi L, Xuemei Z, Ling Y, Changchun C, Zhuo H, Jinyang Q, et al. Correlation between frailty and cardiac structure and function in echocardiography in elderly patients with normal ejection fraction. Aging Clin Exp Res. 2023 Apr 1;35(4):775–84.Associations of Subclinical Cardiovascular Disease With Frailty [Internet]. Vol. 56, Journal of Gerontology: MEDICAL SCIENCES Copyright. 2001. Available from: https://academic.oup.com/biomedgerontology/article/56/3/M158/545769Topriceanu CC, Moon JC, Hardy R, Chaturvedi N, Hughes AD, Captur G. Longitudinal birth cohort study finds that life-course frailty associates with later-life heart size and function. Sci Rep. 2021 Dec 1;11(1)Kane AE, Bisset ES, Heinze-Milne S, Keller KM, Grandy SA, Howlett SE. 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