Risk factors for longitudinal changes in left ventricular diastolic function among women and men.

Area of Science:

• Cardiology
• Gerontology
• Public Health

Background:

• Left ventricular diastolic function (LVDF) is crucial for cardiac health.
• Understanding longitudinal changes in LVDF and their risk factors is vital for preventative strategies.
• Previous research has not comprehensively evaluated sex-specific, long-term changes in continuous LVDF parameters.

Purpose of the Study:

• To assess changes in LVDF parameters over 11 years in community-dwelling men and women.
• To identify cardiovascular risk factors associated with these longitudinal LVDF changes.

Main Methods:

• Prospective population-based study (Rotterdam Study) involving 870 women and 630 men (mean age 67 years).
• Three echocardiographic assessments over an 11-year follow-up period.
• Linear-mixed effect models (LMM) used to correlate changes in six continuous LVDF parameters with cardiovascular risk factors.

Main Results:

• In women, smoking was linked to adverse changes in deceleration time (DT), while high-density lipoprotein (HDL) cholesterol improved septal e' and E/e' ratio.
• In men, diabetes was associated with detrimental changes in A wave, septal e', and E/e' ratio.
• Higher body mass index (BMI) in men correlated with adverse changes in A wave, E/A ratio, DT, and E/e' ratio.

Conclusions:

• Smoking in women and metabolic factors (diabetes, BMI) in men demonstrated significant adverse associations with longitudinal LVDF changes.
• Favorable effects of HDL were primarily observed in women.
• This study provides novel insights into sex-specific risk factors influencing long-term LVDF trajectories, generating hypotheses for future research.