title: Association of African American race with elevated pulmonary artery diastolic pressure: data from the Heart and Soul Study.
abstract: BACKGROUND
  Whether increased severity of heart failure in African Americans is a result of differences in cardiac physiology is uncertain. The end-diastolic pulmonary regurgitation (EDPR) gradient is associated with abnormal cardiac physiology. We hypothesized that African American race is associated with an elevated EDPR gradient that may partially predispose African Americans to heart failure.
  
  
  METHODS
  The Heart and Soul Study prospectively assessed the EDPR gradient in 480 patients with coronary disease. We used multivariable linear regression to investigate the independent association of African American race with EDPR gradient.
  
  
  RESULTS
  Compared with 393 non-African Americans, the 87 African Americans had similar indices of left ventricular systolic and diastolic function, left ventricular mass index, mitral regurgitation, peak tricuspid regurgitation gradient, and pulmonary velocity time integral. However, the EDPR gradient was significantly higher in African Americans (4.2 +/- 3.3 mm Hg) than in Caucasians (3.1 +/- 2.5 mm Hg) or other racial groups (3.5 +/- 2.7 mm Hg) (P = .008). In a multivariable model, African American race was a significant predictor of elevated EDPR gradient (beta coefficient 0.75, P = .03).
  
  
  CONCLUSIONS
  African American race is independently associated with an elevated EDPR gradient in patients with coronary artery disease.
authors.affiliation: Division of Cardiology, University of California, San Francisco, California 94143-0124, USA. kkhush@medicine.ucsf.edu
authors.forename: Kiran K
authors.initials: KK
authors.lastname: Khush
authors.forename: Sanjiv J
authors.initials: SJ
authors.lastname: Shah
authors.forename: Bryan
authors.initials: B
authors.lastname: Ristow
authors.forename: Teresa
authors.initials: T
authors.lastname: De Marco
authors.forename: Mary A
authors.initials: MA
authors.lastname: Whooley
authors.forename: Nelson B
authors.initials: NB
authors.lastname: Schiller
mesh_terms: D001741:Black or African American / Q000706:statistics & numerical data*; D000368:Aged; D002140:California / Q000453:epidemiology; D015897:Comorbidity; D003324:Coronary Artery Disease / Q000000981:diagnostic imaging* / Q000208:ethnology*; D005260:Female; D006801:Humans; D006976:Hypertension, Pulmonary / Q000000981:diagnostic imaging* / Q000208:ethnology*; D008297:Male; D008875:Middle Aged; D015995:Prevalence; D018570:Risk Assessment / Q000379:methods*; D012307:Risk Factors; D013223:Statistics as Topic; D014463:Ultrasonography