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Progression of left ventricular diastolic dysfunction in ethnic minorities
Insights
Diastolic dysfunction, a precursor to heart failure, progressed in nearly 28% of this ethnic minority cohort. Understanding risk factors is key for early intervention in diastolic dysfunction.
Area of Science:
- Cardiology
- Echocardiography
- Heart Failure Research
Background:
- Diastolic heart failure accounts for approximately 50% of all heart failure cases.
- Asymptomatic diastolic dysfunction often precedes symptomatic diastolic heart failure, indicating a critical window for intervention.
- Prior research on diastolic dysfunction progression has primarily focused on non-minority populations.
Purpose of the Study:
- To investigate the rate of progression of diastolic dysfunction.
- To identify risk factors associated with diastolic dysfunction progression in a predominantly ethnic minority population.
Main Methods:
- Retrospective cohort study utilizing echocardiogram and Electronic Health Record (EHR) data.
- Included individuals with at least two echocardiograms showing diastolic dysfunction between 2006 and 2012.
- Analyzed changes in diastolic function grade over time and associated risk factors.
Main Results:
- Reviewed 154 patients (496 echocardiograms); mean follow-up was 1.9 years.
- Nearly 28% of the cohort showed worsening diastolic dysfunction grade over time.
- Diastolic dysfunction remained unchanged in 62% and improved in 9.7% of patients.
Conclusions:
- Diastolic dysfunction progression occurred at a slightly higher rate in this predominantly ethnic minority population compared to previous studies.
- Findings underscore the progressive nature of diastolic dysfunction over time.
- Identifying cardiovascular disease risk factors that accelerate progression is crucial for optimizing interventions for asymptomatic diastolic dysfunction.
Background:
Approximately 50 % of heart failure cases are due to diastolic failure. Generally, it is thought that asymptomatic diastolic dysfunction precedes the development of diastolic heart failure, representing an ideal time for intervention. Previous studies have examined progression rates in non-minority populations only.
Objective:
To determine the rate of diastolic dysfunction progression and the associated risk factors in a predominately ethnic minority population.
Design, Setting, And Participants:
A retrospective cohort study of participants drawn from the echocardiogram database and Electronic Health Record (EHR) for an academic medical center. Individuals with 2 or more echocardiograms showing diastolic dysfunction during a six year study period (2006–2012) were selected.
Main Outcome Measures:
Change in diastolic function grade over time and risk factors associated with this change.
Results:
During the six-year retrospective study period, 154 patients with 2 or more echocardiograms demonstrating diastolic dysfunction were reviewed; these represented 496 echocardiograms. The mean time between echocardiograms was 1.9 years. Mean age was 64.6 (±10.1) years,81 % were female, and average BMI was 30.5(±7.4). The majority of subjects had Grade I diastolic dysfunction at the initial examination (87.7 % (n = 135)); 9 % (n = 14) had Grade II, and 3 % (n = 5) had Grade III. Approximately 27.9 % (n = 43) of the study cohort demonstrated overall worsening grade of diastolic dysfunction over time. Diastolic dysfunction grade was unchanged in 62 %(n = 96), improved in 9.7 % (n = 14), and worsened then improved in 0.7 % (n = 1).
Conclusions:
Our study showed a slightly higher rate of diastolic dysfunction progression in this predominately ethnic minority population. This is consistent with a previous study in a non-minority population demonstrating the progressive nature of diastolic dysfunction over time.Understanding the role of cardiovascular disease risk factors in accelerating progression rates from asymptomatic diastolic dysfunction to symptomatic stages is paramount to optimize intervention strategies.
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