Next Article in Journal
Leukocyte Telomere Length and Long-Term Clinical Outcomes in Women with Systemic Lupus Erythematosus: A Prospective Cohort Study
Previous Article in Journal
Echocardiogram Testing in Patients with Post-COVID-19 Condition: A Systematic Review and Meta-Analysis
Previous Article in Special Issue
Heart Failure in Older Adults: Real-World Outcomes and Patient Profiles by Admission Service and Sex
 
 
Search for Articles:
Title / Keyword
Author / Affiliation / Email
Journal
Article Type
 
 
Advanced Search
 
Section
Special Issue
Volume
Issue
Number
Page
 
Journals
JCM
Volume 15
Issue 12
10.3390/jcm15124645
jcm-logo
Submit to this Journal Review for this Journal Propose a Special Issue
► Article Menu

Article Menu

share Share announcement Help format_quote Cite
first_page
settings
Order Article Reprints
Font Type:
Arial Georgia Verdana
Font Size:
Aa Aa Aa
Line Spacing:
Column Width:
Background:
This is an early access version, the complete PDF, HTML, and XML versions will be available soon.
Article

Frailty and Echocardiographic Indices of Diastolic Function in Older Adults: A Cross-Sectional Analysis

by
Dimitrios Anagnostou
1,2,3,
Georgia Vamvakou
1,2,
Zoi Kollia
1,
Christos Chitas
1,2,
Nikolaos Theodorakis
1,2,3,
Sofia Kalantzi
1,4,
Aikaterini Spyridaki
1,4,
Vassilis Milionis
1,5,
Michalitsa Christodoulou
1,
Ioanna Nella
1,
Efi Gourzoulidou
1,
Sofia Athinaiou
1,
Gesthimani Triantafylli
1 and
Maria Nikolaou
1,2,*
1
Geriatric Outpatient Clinic 65+, Sismanogleio-Amalia Fleming General Hospital, 14 25is Martiou Str., 15127 Melissia, Greece
2
Department of Cardiology, Sismanogleio-Amalia Fleming General Hospital, 14 25is Martiou Str., 15127 Melissia, Greece
3
School of Medicine, National and Kapodistrian University of Athens, 75 Mikras Asias, 11527 Athens, Greece
4
Department of Internal Medicine, Sismanogleio-Amalia Fleming General Hospital, 14 25is Martiou Str., 15127 Melissia, Greece
5
Department of Psychiatry, Sismanogleio-Amalia Fleming General Hospital, 1 Sismanogleiou Str., 15126 Marousi, Greece
*
Author to whom correspondence should be addressed.
J. Clin. Med. 2026, 15(12), 4645; https://doi.org/10.3390/jcm15124645 (registering DOI)
Submission received: 7 May 2026 / Revised: 29 May 2026 / Accepted: 12 June 2026 / Published: 15 June 2026
(This article belongs to the Special Issue Cardiovascular Disease in the Elderly: Cardiogeriatric Assessment, Prevention, Treatment Outcomes and Perspectives)
Versions Notes

Abstract

Background: Frailty in older adults is linked to adverse cardiovascular outcomes, but its relationship with echocardiographic markers of diastolic function remains unclear. We examined associations between frailty measures and indices of diastolic function in community-dwelling older adults. Methods: This cross-sectional study included 537 adults aged ≥65 years from a multidisciplinary outpatient clinic. Frailty was assessed using the Fried phenotype, Clinical Frailty Scale (CFS), gait speed, and handgrip strength. Associations with diastolic indices were analyzed using multivariable regression with sequential adjustment. Sensitivity analysis was performed via matching. Results: According to the Fried phenotype, 30.8% of participants were robust, 59.7% pre-frail, and 9.5% frail. Indexed left atrial dimension (LAi) was consistently higher in frail individuals. Frailty was also associated with higher odds of elevated right ventricular systolic pressure (>35 mmHg) in unadjusted analyses. Using the CFS, individuals with a score higher than 3 had significantly higher NT-proBNP levels compared to those with a score of 1–2. Higher gait speed and handgrip strength were associated with more favorable cardiac structure, including smaller left heart chamber sizes, and lower natriuretic peptide levels. Conclusions: Frailty was independently associated with structural and functional markers of diastolic dysfunction in older adults, particularly left atrial enlargement (as captured in Fried) and NT-proBNP elevation (as captured in CFS), supporting the integration of frailty assessment into cardiovascular risk evaluation.
Keywords: frailty; diastole; fried; CFS; diastolic dysfunction; left atrium frailty; diastole; fried; CFS; diastolic dysfunction; left atrium

Share and Cite

MDPI and ACS Style

Anagnostou, D.; Vamvakou, G.; Kollia, Z.; Chitas, C.; Theodorakis, N.; Kalantzi, S.; Spyridaki, A.; Milionis, V.; Christodoulou, M.; Nella, I.; et al. Frailty and Echocardiographic Indices of Diastolic Function in Older Adults: A Cross-Sectional Analysis. J. Clin. Med. 2026, 15, 4645. https://doi.org/10.3390/jcm15124645

AMA Style

Anagnostou D, Vamvakou G, Kollia Z, Chitas C, Theodorakis N, Kalantzi S, Spyridaki A, Milionis V, Christodoulou M, Nella I, et al. Frailty and Echocardiographic Indices of Diastolic Function in Older Adults: A Cross-Sectional Analysis. Journal of Clinical Medicine. 2026; 15(12):4645. https://doi.org/10.3390/jcm15124645

Chicago/Turabian Style

Anagnostou, Dimitrios, Georgia Vamvakou, Zoi Kollia, Christos Chitas, Nikolaos Theodorakis, Sofia Kalantzi, Aikaterini Spyridaki, Vassilis Milionis, Michalitsa Christodoulou, Ioanna Nella, and et al. 2026. "Frailty and Echocardiographic Indices of Diastolic Function in Older Adults: A Cross-Sectional Analysis" Journal of Clinical Medicine 15, no. 12: 4645. https://doi.org/10.3390/jcm15124645

APA Style

Anagnostou, D., Vamvakou, G., Kollia, Z., Chitas, C., Theodorakis, N., Kalantzi, S., Spyridaki, A., Milionis, V., Christodoulou, M., Nella, I., Gourzoulidou, E., Athinaiou, S., Triantafylli, G., & Nikolaou, M. (2026). Frailty and Echocardiographic Indices of Diastolic Function in Older Adults: A Cross-Sectional Analysis. Journal of Clinical Medicine, 15(12), 4645. https://doi.org/10.3390/jcm15124645

Note that from the first issue of 2016, this journal uses article numbers instead of page numbers. See further details here.

Article Metrics

Article metric data becomes available approximately 24 hours after publication online.
Back to TopTop