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Updated: Jun 11, 2026
Evaluation of Left Ventricular Structure and Function using 3D Echocardiography
Published on: October 28, 2020
Race/ethnic disparities in left ventricular diastolic function in a triethnic community cohort
Cesare Russo1, Zhezhen Jin, Shunichi Homma
1Department of Medicine, Columbia University, New York, NY 10032, USA.
Insights
Race-ethnic differences in left ventricular diastolic function exist, with Black and Hispanic individuals showing poorer function. However, modifiable risk factors and sociodemographics, not intrinsic differences, explain these disparities in diastolic function.
Area of Science:
- Cardiology
- Cardiovascular Imaging
- Health Disparities
Background:
- Significant racial-ethnic disparities are observed in cardiovascular disease (CVD) risk factors, morbidity, and mortality.
- Left ventricular diastolic dysfunction (LVDD) is a critical predictor of mortality and adverse cardiovascular outcomes, including heart failure.
- Understanding race-ethnic variations in LVDD may elucidate underlying mechanisms contributing to CVD outcome disparities.
Purpose of the Study:
- To investigate potential race-ethnic differences in left ventricular diastolic function.
- To determine if observed disparities in diastolic function contribute to known racial-ethnic variations in cardiovascular outcomes.
Main Methods:
- Utilized two-dimensional echocardiography in 760 participants from the Cardiac Abnormalities and Brain Lesions study (539 Hispanic, 117 non-Hispanic Black, 104 non-Hispanic White).
- Assessed left ventricular diastolic function using standard Doppler flow profiles and tissue Doppler imaging, calculating transmitral flow (E/A) and mitral annular early diastolic velocities (E/E').
Main Results:
- Compared to non-Hispanic Whites, Black and Hispanic participants exhibited higher BMI, hypertension, and diabetes prevalence, and lower education levels.
- In age- and sex-adjusted analyses, Hispanics and Blacks demonstrated worse diastolic function indices than Whites.
- These race-ethnic differences in diastolic function were diminished after adjusting for modifiable cardiovascular risk factors and sociodemographic variables.
Conclusions:
- Distinct differences in left ventricular diastolic function were identified among different race-ethnic groups.
- The majority of these observed race-ethnic variations in diastolic function appear attributable to modifiable cardiovascular risk factors and sociodemographic factors, rather than inherent biological differences.
Background:
Racial-ethnic disparities exist in cardiovascular risk factors, morbidity, and mortality. Left ventricular diastolic dysfunction is a predictor of mortality and of cardiovascular outcome including incident heart failure. We sought to assess whether race-ethnic differences in diastolic function exist. Such differences may contribute to the observed disparities in cardiovascular outcomes.
Methods:
Two-dimensional echocardiography was performed in 760 participants (539 Hispanic, 117 non-Hispanic black, 104 non-Hispanic white) from the Cardiac Abnormalities and Brain Lesions study. Left ventricular diastolic function was assessed by standard Doppler flow profile and tissue Doppler imaging. Early (E) and late (A) transmitral diastolic flow, and mitral annulus early diastolic velocities (E') were recorded; and E/A and E/E' ratios were calculated.
Results:
Blacks and Hispanics had higher body mass index (P = .04, P < .01), higher prevalence of hypertension (both Ps
Conclusions:
Differences in left ventricular diastolic function exist between race-ethnic groups. However, modifiable cardiovascular risk factors and sociodemographic variables, rather than intrinsic race-ethnic heterogeneity, seem to explain most of the observed differences.
