Skip to main content
SpringerLink
Log in

Progression of Left Ventricular Diastolic Dysfunction in Ethnic Minorities

  • Original Article
  • Published:
High Blood Pressure & Cardiovascular Prevention Aims and scope Submit manuscript

Abstract

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.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Fig. 1
Fig. 2

Similar content being viewed by others

References

  1. Joynt K, Oray E, Jha A. Thirty-day readmission rates for Medicare beneficiaries by race and site of care. JAMA. 2011;305:675–81.

    Article  CAS  PubMed Central  PubMed  Google Scholar 

  2. Barretto A, Del Carlo C, Cardoso J. Hospital readmissions and death from Heart Failure-rates still alarming. Arg Bras Cardiol. 2008;91:335–41.

    Article  Google Scholar 

  3. Borlaug B, Redfield M. Diastolic and systolic heart failure are distinct phenotypes within the heart failure spectrum. Circulation. 2011;123:2006–13.

    Article  PubMed Central  PubMed  Google Scholar 

  4. Wood P, Piran S, Liu P. Diastolic heart failure: progress, treatment challenges, and prevention. Can J Cardiol. 2011;27:302–10.

    Article  PubMed  Google Scholar 

  5. Vogel M, Slusser J, Hodge D, et al. The natural history of preclinical diastolic dysfunction. Circ Heart Fail. 2012;5:144–51.

    Article  PubMed Central  PubMed  Google Scholar 

  6. Moe G, Tu J. Heart failure in the ethnic minorities. Curr Opin Cardiol. 2010;25:124–40.

    Article  PubMed  Google Scholar 

  7. Kane G, Karon B, Mahoney D, et al. Progression of left ventricular diastolic dysfunction and risk of heart failure. JAMA. 2011;306:856–63.

    Article  CAS  PubMed Central  PubMed  Google Scholar 

  8. Russo C, Jin Z, Homma S, et al. Race/ethnic disparities in left ventricular diastolic function in a triethnic community cohort. Am Heart J. 2010;160:152–8.

    Article  PubMed Central  PubMed  Google Scholar 

  9. Paneni F, Gregori M, Tocci G, et al. Do diabetes, metabolic syndrome or their association equally affect biventricular function? A tissue Doppler study. Hypertension Res. 2013;36:36–42.

    Article  CAS  Google Scholar 

  10. Alijaroudi W, Alraises M, Halley C, et al. Impact of progression of diastolic dysfunction on mortality in patients with normal ejection fraction. Circulation. 2012;125:782–8.

    Article  Google Scholar 

  11. Fischer M, Baessler A, Hense H, et al. Prevalence of left ventricular diastolic dysfunction in the community. Results from a Doppler echocardiographic-based survey of a population sample. Eur Heart J. 2003;24:320–8.

    Article  CAS  PubMed  Google Scholar 

  12. Chen H, Lainchbury J, Senni M, et al. Diastolic heart failure in the community: clinical profile, natural history, therapy, and impact of proposed diagnostic criteria. J Cardiac Fail. 2002;8:279–87.

    Article  Google Scholar 

  13. de Simone G, Kitzman D, Chinali M, et al. Left ventricular concentric geometry is associated with impaired relaxation in hypertension: the HyperGEN study. Eur Heart J. 2005;26:1039–45.

    Article  PubMed  Google Scholar 

  14. Gradman A, Alfayoumi F. From left ventricular hypertrophy to congestive heart failure: management of hypertensive heart disease. Prog Cardiovasc Dis. 2006;48:326–41.

    Article  PubMed  Google Scholar 

  15. Aljaroudi W, Thomas J, Rodriguez L, et al. Prognostic value of diastolic dysfunction: a state of the art review. Cardiol Rev. 2013.

Download references

Acknowledgment

The project described was supported by the National Center for Advancing Translational Sciences, National Institutes of Health, through Grant UL1TR000050. The content is solely the responsibility of the authors and does not necessarily represent the official views of the NIH.

Author information

Authors and Affiliations

  1. University of Illinois Hospital and Health Sciences System, Chicago, IL, USA

    Heather M. Prendergast, Martha Daviglus, Jared Marcucci, E. Bradshaw Bunney & Tamara O’Neal

  2. Brown University Section of Cardiology, Providence, RI, USA

    Samuel Dudley

  3. Rush Medical Center, Chicago, IL, USA

    John Kane & Dejuran Richardson

  4. Resurrection Medical Center, Chicago, IL, USA

    Anthony Acosta

  5. Department of Emergency Medicine, University of Illinois Hospital and Health Sciences System, Room 471-H College of Medicine East, 808 South Wood Street, Chicago, IL, 60612-7354, USA

    Heather M. Prendergast

Authors
  1. Heather M. Prendergast
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Samuel Dudley
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. John Kane
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. Martha Daviglus
    View author publications

    You can also search for this author in PubMed Google Scholar

  5. Jared Marcucci
    View author publications

    You can also search for this author in PubMed Google Scholar

  6. Anthony Acosta
    View author publications

    You can also search for this author in PubMed Google Scholar

  7. E. Bradshaw Bunney
    View author publications

    You can also search for this author in PubMed Google Scholar

  8. Dejuran Richardson
    View author publications

    You can also search for this author in PubMed Google Scholar

  9. Tamara O’Neal
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Heather M. Prendergast.

Rights and permissions

Reprints and permissions

About this article

Cite this article

Prendergast, H.M., Dudley, S., Kane, J. et al. Progression of Left Ventricular Diastolic Dysfunction in Ethnic Minorities. High Blood Press Cardiovasc Prev 21, 205–211 (2014). https://doi.org/10.1007/s40292-013-0031-2

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s40292-013-0031-2

Keywords

Search

Navigation