title: Prevalence of left ventricular diastolic dysfunction in European populations based on cross-validated diagnostic thresholds.
abstract: BACKGROUND
  Different diagnostic criteria limit comparisons between populations in the prevalence of diastolic left ventricular (LV) dysfunction. We aimed to compare across populations age-specific echocardiographic criteria for diastolic LV dysfunction as well as their correlates and prevalence.
  
  
  METHODS
  We measured the E and A peaks of transmitral blood flow by pulsed wave Doppler and the e' and a' peaks of mitral annular velocities by tissue Doppler imaging (TDI) in 2 cohorts randomly recruited in Belgium (n = 782; 51.4% women; mean age, 51.1 years) and in Italy, Poland and Russia (n = 476; 55.7%; 44.5 years).
  
  
  RESULTS
  In stepwise regression, the multivariable-adjusted correlates of the transmitral and TDI diastolic indexes were similar in the 2 cohorts and included sex, age, body mass index, blood pressure and heart rate. Similarly, cut-off limits for the E/A ratio (2.5th percentile) and E/e' ratio (97.5th percentile) in 338 and 185 reference subjects free from cardiovascular risk factors respectively selected from both cohorts were consistent within 0.02 and 0.26 units (median across 5 age groups). The rounded 2.5th percentile of the E/A ratio decreased by ~0.10 per age decade in these apparently healthy subjects. The reference subsample provided age-specific cut-off limits for normal E/A and E/e' ratios. In the 2 cohorts combined, diastolic dysfunction groups 1 (impaired relaxation), 2 (possible elevated LV filling pressure) and 3 (elevated E/e' and abnormally low E/A) encompassed 114 (9.1%), 135 (10.7%), and 40 (3.2%) subjects, respectively.
  
  
  CONCLUSIONS
  The age-specific criteria for diastolic LV dysfunction were highly consistent across the study populations with an age-standardized prevalence of 22.4% vs. 25.1%.
authors.affiliation: The First Department of Cardiology and Hypertension, Jagiellonian University, Kraków, Poland.
authors.forename: Malgorzata
authors.initials: M
authors.lastname: Kloch-Badelek
authors.forename: Tatiana
authors.initials: T
authors.lastname: Kuznetsova
authors.forename: Wojciech
authors.initials: W
authors.lastname: Sakiewicz
authors.forename: Valérie
authors.initials: V
authors.lastname: Tikhonoff
authors.forename: Andrew
authors.initials: A
authors.lastname: Ryabikov
authors.forename: Arantxa
authors.initials: A
authors.lastname: González
authors.forename: Begoña
authors.initials: B
authors.lastname: López
authors.forename: Lutgarde
authors.initials: L
authors.lastname: Thijs
authors.forename: Yu
authors.initials: Y
authors.lastname: Jin
authors.forename: Sofia
authors.initials: S
authors.lastname: Malyutina
authors.forename: Katarzyna
authors.initials: K
authors.lastname: Stolarz-Skrzypek
authors.forename: Edoardo
authors.initials: E
authors.lastname: Casiglia
authors.forename: Javier
authors.initials: J
authors.lastname: Díez
authors.forename: Krzysztof
authors.initials: K
authors.lastname: Narkiewicz
authors.forename: Kalina
authors.initials: K
authors.lastname: Kawecka-Jaszcz
authors.forename: Jan A
authors.initials: JA
authors.lastname: Staessen
mesh_terms: D018619:Echocardiography, Doppler, Pulsed / Q000706:statistics & numerical data*; D054459:Elasticity Imaging Techniques / Q000706:statistics & numerical data*; D005060:Europe; D005260:Female; D006801:Humans; D008297:Male; D015995:Prevalence; D015203:Reproducibility of Results; D018570:Risk Assessment; D012307:Risk Factors; D012680:Sensitivity and Specificity; D018487:Ventricular Dysfunction, Left / Q000000981:diagnostic imaging* / Q000453:epidemiology*