Echocardiogram
Ultrasound of the heart — assesses chamber size, valve function, ejection fraction, and diastolic function.
Optimal Range
Ejection fraction 55-70% · Normal diastolic function
Risk-Stratified Targets
| Population / Context | Target |
|---|---|
| Ejection fraction — normal | 55–70% |
| Ejection fraction — mildly reducedWarrants evaluation and monitoring | 40–54% |
| Ejection fraction — moderately reduced | 30–39% |
| Ejection fraction — severely reducedHeart failure; urgent cardiology management | < 30% |
Why It Matters
Echocardiography detects structural heart disease including valve abnormalities, cardiomyopathy, and diastolic dysfunction — conditions that are common with aging and often asymptomatic until advanced. Early detection enables medical and lifestyle intervention.
Understanding Echocardiogram
Echocardiography uses ultrasound waves to create real-time images of the heart, providing detailed assessment of chamber sizes, wall thickness, valve function, blood flow patterns, and both systolic (pumping) and diastolic (filling) function. It is non-invasive, radiation-free, and the most widely used cardiac imaging modality.
Left ventricular ejection fraction (LVEF) — the percentage of blood pumped out with each heartbeat — is the headline metric, with 55–70% considered normal. However, diastolic function assessment is arguably more important for longevity screening. Diastolic dysfunction (impaired relaxation and filling of the heart) is extremely common with aging, hypertension, and metabolic disease, and is the primary mechanism of heart failure with preserved ejection fraction (HFpEF) — the most common form of heart failure in older adults. Early diastolic dysfunction is detectable by echocardiography years before symptoms develop.
Valvular heart disease is another critical finding. Aortic stenosis (the most common valve disease in the elderly, and associated with elevated Lp(a)), mitral regurgitation, and mitral valve prolapse can all be detected and staged by echocardiography. Cardiac structural abnormalities like left ventricular hypertrophy (thickened heart wall, often from chronic hypertension) and atrial enlargement (a precursor to atrial fibrillation) provide important information about the long-term effects of risk factors on the heart. A baseline echocardiogram at age 40–50 is recommended by many longevity physicians, with repeat studies guided by findings and risk factors.