Electrocardiographic changes in centenarians: a study on 42 subjects and comparison with the literature.

BACKGROUND: Aging is associated with extensive and pervasive changes in cardiovascular structure and function, which may result in electrocardiographic alterations. The typical modifications seen in an electrocardiogram (ECG) in elders are: prolonged PR and QT intervals, QRS left-axis deviation and microvolt T wave. Several studies have included elderly people, but not long-living elderly and centenarians in particular who represent an increasing part of the population. OBJECTIVE: The aim of this study was to investigate the electrocardiographic findings in a population of centenarians and to compare the results with the few studies present in the literature. METHODS: We analyzed 42 healthy centenarians (12 males, 30 females; average age 101.43 ± 1.80 years) living in Messina, a municipality of Eastern Sicily, in Italy. They were clinically and functionally evaluated. All ECGs were analyzed by a single observer blind to clinical data. We assessed survival by phone recall. RESULTS: PR interval mean duration was 190 ± 3.3 ms, QRS 90 ± 1.4 ms, QTc interval mean duration was 370 ± 3.5 ms. Entirely normal ECG recordings were found in 7 centenarians (16.6%). The most frequently observed abnormalities included left-axis deviation and left anterior hemiblock in 16 centenarians (38.09%), left ventricular hypertrophy and aspecific ST-T wave abnormalities in 13 subjects (30.95%). We found no statistically significant differences between men and women. The mean age at death was 102.44 ± 2.45, and we did not find significant differences in age at death in long-living elderly in relation to different electrocardiographic findings. Comparing our results with two previous studies in the literature, the first conducted in Switzerland [Cornu: Rev Med Suisse Rom 1979;99:107-113] and the second in Nebraska [Lakkireddy et al.: Am J Cardiol 2003;92:1249-1251], we found a higher frequency of left ventricular hypertrophy that was compatible with the prevalence of hypertension in our centenarians (33.3%). Moreover, we did not find left bundle branch block, and the frequency of premature beats was remarkably less than that observed in the Swiss and US studies. CONCLUSIONS: Considering the increasing rate of centenarians, we believe that the results of the present study on electrocardiographic changes in centenarians may also be useful in clinical practice.

Healthy centenarians show high levels of circulating interleukin-22 (IL-22).

Aging is characterized by a progressive alteration of homeostatic mechanisms modulated by environmental and genetic factors. It is associated with a pro-inflammatory status. In centenarians, an increase of pro-inflammatory cytokine production balanced by anti-inflammatory immune response that would promote longevity is observed. Cytokine dysregulation is believed to play a key role in the proposed remodeling of the immune-inflammatory responses accompanying old age. IL-22 is a pro-inflammatory cytokine belonging to the IL-10 family and represents an important effector molecule of activated T helper (Th)-22, Th-1, and Th-17 cells. We recruited 17 healthy centenarians (4 males, 13 females, range 100-105 years). All ultralongeval subjects were living at home or in a nursing home. Sixteen healthy, sex-matched individuals (4 males, 12 females, range 60-95 years) were also recruited as controls. Centenarians displayed significantly higher circulating IL-22 levels compared to control population (45.7±66.9 pg/ml versus 11.1±6.5 pg/ml; p=0.031). It's well known that IL-22 is a pro-inflammatory cytokine produced by activated T lymphocytes and NK cells. IL-22 stimulates the production of acute phase reactants and promotes the antimicrobial defense. The results of the present study show, for the first time, that there is an increase of IL-22 in healthy centenarians. This pro-inflammatory condition probably is protective against infection, promoting the longevity of these subjects.