Progression of Left Ventricular Diastolic Dysfunction in Ethnic Minorities
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ORIGINAL ARTICLE
Progression of Left Ventricular Diastolic Dysfunction in Ethnic Minorities Heather M. Prendergast • Samuel Dudley • John Kane • Martha Daviglus • Jared Marcucci • Anthony Acosta • E. Bradshaw Bunney • Dejuran Richardson • Tamara O’Neal
Received: 4 August 2013 / Accepted: 22 October 2013 / Published online: 15 November 2013 Ó Springer International Publishing Switzerland 2013
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 sixyear study period (2006–2012) were selected.
H. M. Prendergast M. Daviglus J. Marcucci E. B. Bunney T. O’Neal University of Illinois Hospital and Health Sciences System, Chicago, IL, USA H. M. Prendergast (&) 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 e-mail: [email protected] S. Dudley Brown University Section of Cardiology, Providence, RI, USA
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. Keywords Diastolic dysfunction Ethnic minorities Progression
J. Kane
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