A novel non-invasive estimate of biological age: can an echocardiogram measure the patient’s age?

The impact of aging balances the cumulative burden of chronic stress and life events, the allostatic load, with the capacity for physiologic adaptation to these stressors.This load results in many structural and functional changes, particularly involving the heart and the vascular system.The associated oxidative stress, chronic low-grade inflammation, and decreased cellular regenerative capacity result in lower myocyte number, myocyte hypertrophy, and increased collagen deposition in the extracellular matrix of the heart. 1 The resulting myocardial fibrosis and stiffness can involve the atria, leading to left atrial myopathy, atrial enlargement, and atrial fibrillation, or the ventricles leading to concentric remodelling, hypertrophy, and diastolic dysfunction. 2Concurrent changes in the vascular system include endothelial dysfunction and arterial intimal-medial thickening and can result in wall stiffness and arterial dilation. 1To date, age is considered the strongest determinant of not only aging but also cardiovascular health.For example, age was shown to be stronger than magnetic resonance imaging measures in determining the risk of stroke. 3espite the well-established association between aging and cardiovascular disease, it is widely accepted that individuals age at different rates.This inter-individual variability in aging results from a complex interaction between genetic predisposition, lifestyle, the environment, accompanying diseases, chronic load, and adaptation.As a result, different measures have been developed to better reflect health status while accounting for these variations, more than chronological age, leading to the concept of 'biological age'.Frailty index is one commonly used measure that incorporates symptoms, signs, functional impairments,