title: Association between cardiac disorders and a decades-previous history of diphtheria.
abstract: A long, prior history of diphtheria is common among middle-aged and elder European adults. The aim of the present study was to determine whether the risk of reduced ventricular function and impaired intraventricular conduction is increased in individuals with a history of diphtheria. A study population of 2,480 subjects (1,222 women) aged 45 years or older who were recruited for the Study of Health in Pomerania were available for the present analyses. Left ventricular function was assessed by echocardiography. Intraventricular conduction blocks were diagnosed using electrocardiograms. Multivariable analyses revealed that individuals with a history of diphtheria had neither an increased odds for reduced fractional shortening (OR 1.21, 95% CI 0.69-2.11; p=0.51) nor an increased odds for intraventricular conduction blocks (OR 0.90, 95% CI 0.55-1.46; p=0.67). However, regression models revealed two-way interactions between the exposure variable and hypertension with respect to both endpoints. A history of diphtheria increased the odds for both endpoints in normotensive but not in hypertensive individuals. The findings show that a history of diphtheria several decades previously in a patient is a risk marker for reduced cardiac function and impaired intraventricular conduction in individuals at low risk for these disorders.
authors.affiliation: Institute of Epidemiology and Social Medicine, Ernst Moritz Arndt University, Walther Rathenau Strasse 48, 17487, Greifswald, Germany. voelzke@uni-greifswald.de
authors.forename: H
authors.initials: H
authors.lastname: Völzke
authors.forename: C
authors.initials: C
authors.lastname: Warnke
authors.forename: M
authors.initials: M
authors.lastname: Dörr
authors.forename: A
authors.initials: A
authors.lastname: Kramer
authors.forename: L
authors.initials: L
authors.lastname: Guertler
authors.forename: W
authors.initials: W
authors.lastname: Hoffmann
authors.forename: J A
authors.initials: JA
authors.lastname: Kors
authors.forename: U
authors.initials: U
authors.lastname: John
authors.forename: S B
authors.initials: SB
authors.lastname: Felix
mesh_terms: D000328:Adult; D000368:Aged; D004165:Diphtheria / Q000453:epidemiology*; D005260:Female; D005858:Germany / Q000453:epidemiology; D006331:Heart Diseases / Q000453:epidemiology* / Q000382:microbiology; D006801:Humans; D008297:Male; D008875:Middle Aged; D016277:Ventricular Function, Left