目的 分析中国老年重度瓣膜性心脏病（瓣膜病）患者的临床特征及老年综 合评估情况，包括合并症、形态结构、病变特点、衰弱、认知功能等。 方法 本研究为前瞻性、多中心注册登记研究，纳入自 2021 年 9 月至 2023 年 9 月全国 20 家研究中心的老年重度瓣膜病患者。详细收集基本人口学信息、 疾病诊断、病情严重程度、影像学检查、形态结构、生活质量、衰弱程度以及 认知状态等完整信息，分析患者的临床特点及老年综合评估状况。 结果 研究共纳入≥65 岁老年瓣膜病患者 6161 例，平均年龄 73.47±6.11 岁，女性 2776 例（45.1%）。反流性瓣膜病最常见，其中二尖瓣反流 4645 例 （75.4%）。主动脉瓣狭窄 2683 例（43.5%），重度狭窄 2314 例 （占 37.6%）。 退行性改变是瓣膜狭窄的病因，在中重度主动脉瓣狭窄患者中占 88.5%。胸闷 为最常见的临床症状，共 4059 例（65.9%）。NYHA 分级Ⅲ/Ⅳ级患者占 66.1%。 最常见合并症为高血压 3306 例（53.82%），其次为心房颤动/扑动和冠心病，分 别为 1932 例（31.5%）和 1700 例（27.7%）。既往接受瓣膜有创治疗的患者为 302 例（4.9%），外科瓣膜置换术为 231 例（3.7%），仅接受过介入治疗的患者 为 49 例（0.8%）。老年综合评估部分，近期体重下降>4.5kg 或 >5%体重的患者 为 725 例（11.8%），1 周内感到疲乏天数≥3 天的患者占 36.2%。测得左手握力 平均值 18.94±7.62 kg，右手为 21.01±8.16 kg；每周散步时间不足 2 小时患 者为 3499 例（56.8%）；5 米步速平均值为 8.16 秒。认知功能评估方面，记词 测试中可重复 1 个和 2 个词汇的患者分别为 638（10.4%）和 1256（20.5%）， 完全无法回忆并重复的患者 752 例（12.3%），MMSE 量表平均值为 25.83±4.30 分。 结论 本研究中老年 VHD 的主要病因为瓣膜退行性改变，胸闷、心悸等临 床症状最常见，多数患者存在心功能不全，且合并以高血压、房颤等心血管系 统疾病为主的慢性合并症。此外，听力障碍、骨质疏松等老年患者特有的合并 症同样常见。在通过营养状态、活动能力及认知水平等方面对本研究患者进行 老年综合评估后发现，营养状态不佳、衰弱状况及认知功能减退的状况普遍。 应建立适合老年瓣膜病患者的标准评估，从而优化干预治疗策略和临床路径， 同时改善老年患者的整体功能和生活质量。 

Objective To investigate the clinical characteristics and comprehensive geriatric assessment of elderly patients with valvular heart disease (VHD) in China, and to evaluate the role of comorbidities, imaging features, frailty, cognitive function and other information in optimizing the treatment decision and clinical pathway of elderly patients with valvular disease. Methods This prospective and multicentered study included elderly patients with severe valvular disease from 20 research centers in China from December 2020 to September 2021. Complete information such as basic demographic information, disease diagnosis, disease severity, quality of life, frailty, and cognitive status was collected in detail. The clinical characteristics and the status of the comprehensive geriatric assessment (CGA) were analyzed through observational studies. Results A total of 6161 elderly patients (≥65 years of age) with VHD were enrolled in the study, with a mean age of 73.47±6.11 years and 2776 (45.1%) were female. Regurgitant valve disease was the most common, among which mitral regurgitation was found in 4645 patients (75.4%). Aortic stenosis was found in 2683 patients (43.5%), with severe stenosis accounting for 2314 cases (37.6%). Degenerative changes were the mian cause, accounting for 88.5% of patients with moderate to severe aortic stenosis. Chest tightness was the most common clinical symptom in 4059 patients (65.9%), and 66.1% of patients were observed with NYHA functional class III/IV. The most common complication was hypertension in 3306 cases (53.82%), followed by atrial fibrillation/flutter and coronary artery disease in 1932 (31.5%) and 1700 (27.7%) patients, respectively. Previous invasive treatment of valves was performed in 302 patients (4.9%), surgical valve replacement in 231 patients (3.7%), and intervention only in 49 patients (0.8%). In the comprehensive geriatric assessment section, weight loss was observed in 725 patients (11.8%), and fatigue was found in most patients. In terms of physical activity, the mean value of grip force was 18.94±7.62 kg for the left hand and 21.01±8.16 kg for the right hand. 3499 patients (56.8%) took a walk for less than 2 hours per week. The average of 5- meter step speed was 8.16 seconds. For cognitive function assessment, the number of patients who could repeat one and two words in the word recall test was 638 (10.4%) and 1256 (20.5%), respectively, and the number of patients who could not recall and repeat at all was 752 (12.3%). The mean value of the MMSE scale was 25.83±4.30 points. Conclusion In this research, degenerative changes are the main cause of the development and progression of VHD in elderly patients. Clinical symptoms such as chest tightness, palpitations, and cardiac insufficiency are common, and multiple cardiovascular comorbidities can occur in one patient, which complexes the management of VHD. Besides, patients are often debilitated and cognitively impaired. A standard assessment system and risk prediction model for elderly patients should be established to optimize intervention strategies and clinical pathways, with the goal of improving the overall function and quality of life of elderly patients while alleviating their condition.