ETIOLOGY AND PRECIPITATING FACTORS
HF etiology in older individuals is multifactorial and unique because of age-related changes and comorbidities. HF in younger patients typically results from left ventricular systolic dysfunction; however, with increased age, patients tend to present more with preserved or near normal systolic function.
HF with a decreased ejection fraction because of ischemic cardiomyopathy is more prevalent in elderly male populations.
7
Elderly women tend to have diastolic HF with preserved left ventricular (LV) function commonly caused by chronic systolic hypertension.
6,7
Normal cardiovascular aging significantly affects cardiac output, LV filling, and older adults’ ability to respond to HF onset (Table 1).
These alterations lead to a marked reduction in cardiovascular reserve and a shift in the LV pressurevolume relationship; thus, a small increase in LV
8
6