Distribution and determinants of Doppler-derived diastolic flow indices in African Americans: the Jackson Heart Study (JHS).
OBJECTIVE
The objective of this study is to investigate the distribution and determinants of diastolic function in a middle-aged cohort of African Americans (AA).


BACKGROUND
The distribution and determinants of left ventricular (LV) diastolic function in AA are not well-described despite high rates of AA with diastolic heart failure and a five-fold higher risk of death in those with diastolic dysfunction (DD) compared to normal diastolic function.


METHODS
Four categories of diastolic function were defined in JHS participants undergoing echocardiograms at the first examination (2001-2004) using mitral and pulmonary vein velocities. Investigators used logistic regression to assess the independent relation of DD to traditional risk factors and LV systolic dysfunction.


RESULTS
Of the 3,571 study participants (mean age, 56 +/- 12 years; 63.9% female), 70.4% had normal diastolic function, and 18.0%, 10.6%, and 0.9% had mild, moderate, and severe DD, respectively. In the multivariable analysis, DD was significantly related to age (OR 1.2, 95% CI 1.1-1.4), male sex (OR 1.3 CI 1.0-1.5), LV systolic dysfunction (OR 1.5, CI 1.2-2.0), body mass index (OR 0.8, CI 0.8-0.9), and heart rate (OR 1.2; CI 1.1-1.2). The severity of DD was significantly related with age (OR 0.3; CI 0.3, 0.4), male sex (OR 1.6; CI 1.2-2.2), hypertension (OR 0.6, CI 0.4-0.8), and heart rate (OR 0.7; CI 0.6-0.8).


CONCLUSIONS
This is the largest community-based analysis of LV diastolic function in middle-aged AA. DD was present in 29.5% and independently related to several traditional risk factors and LV systolic dysfunction.
Samdarshi
Tandaw E
TE
The University of Mississippi School of Medicine, Jackson, MS 39216, USA.
Taylor
Herman A
HA
Edwards
Derrick Q
DQ
Liebson
Philip R
PR
Sarpong
Daniel F
DF
Shreenivas
Satya S
SS
Howard
George
G
Garrison
Robert J
RJ
Fox
Ervin R
ER
D001741:Black or African American; D015992:Body Mass Index; D003920:Diabetes Mellitus / Q000208:ethnology / Q000503:physiopathology; D003925:Diabetic Angiopathies / Q000000981:diagnostic imaging / Q000208:ethnology / Q000503:physiopathology; D003971:Diastole / Q000502:physiology*; D015150:Echocardiography, Doppler; D005260:Female; D006801:Humans; D008297:Male; D015999:Multivariate Analysis; D015995:Prevalence; D012307:Risk Factors; D013599:Systole / Q000502:physiology; D018487:Ventricular Dysfunction, Left / Q000000981:diagnostic imaging / Q000208:ethnology / Q000503:physiopathology; D016277:Ventricular Function, Left / Q000502:physiology*