Comorbidities and Cardiometabolic Disease: Relationship With Longitudinal Changes in Diastolic Function
Matthew Nayor1, Danielle M Enserro2, Vanessa Xanthakis3
1Framingham Heart Study, Framingham, Massachusetts; Cardiology Division, Department of Medicine, Massachusetts General Hospital, Harvard Medical School, Boston, Massachusetts.
JACC. Heart Failure
|March 12, 2018
Summary
Cardiometabolic risk factors and comorbidities worsen diastolic dysfunction (DD) over time in adults. Moderate or worse DD increases the risk of cardiovascular disease (CVD) or death.
Area of Science:
- Cardiology
- Cardiovascular Research
- Heart Function Studies
Background:
- Longitudinal changes in left ventricular (LV) diastolic dysfunction (DD) and its correlates are not fully understood.
- Clinical risk factors associated with the progression of DD require further investigation.
Purpose of the Study:
- To evaluate the course, correlates, and prognosis of longitudinal changes in LV diastolic dysfunction (DD).
- To assess the impact of risk factors on DD progression and its association with cardiovascular outcomes.
Main Methods:
- Echocardiography was used to assess diastolic function in 1,740 participants from the Framingham Heart Study over a mean interval of 5.6 years.
- Participants had normal LV systolic function and no atrial fibrillation at baseline.
Main Results:
- 12% of individuals with normal-to-mild DD progressed to moderate or worse DD, more common in women and older adults.
- 20% of those with moderate or worse DD regressed to normal-to-mild DD, associated with younger age.
- Age, female sex, blood pressure, BMI, triglycerides, diabetes, and noncardiac comorbidity were associated with worsening DD.
- Moderate or worse DD was linked to a 2.14-fold increased risk of cardiovascular disease (CVD) or death.
Conclusions:
- Cardiometabolic risk factors and noncardiac comorbidities are associated with the progression of diastolic dysfunction in middle-aged to older adults.
- Moderate or worse diastolic dysfunction is a significant predictor of cardiovascular disease or death.
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