title: Prevalence, prospective risk markers, and prognosis associated with the presence of left ventricular diastolic dysfunction in young adults: the coronary artery risk development in young adults study.
abstract: The authors sought to determine the prevalence, prospective risk markers, and prognosis associated with diastolic dysfunction in the Coronary Artery Risk Development in Young Adults (CARDIA) Study. The CARDIA Study cohort includes approximately equal proportions of white and black men and women. The authors collected data on risk markers at year 0 (1985-1986), and echocardiography was done at year 5 when the participants were 23-35 years of age. Participants were followed for 20 years (through 2010) for a composite endpoint of all-cause mortality, myocardial infarction, heart failure, and stroke. Diastolic function was defined according to a validated hierarchical classification algorithm. In the 2,952 participants included in the primary analysis, severe diastolic dysfunction was present in 1.1% and abnormal relaxation was present in 9.3%. Systolic blood pressure at year 0 was associated with both severe diastolic dysfunction and abnormal relaxation 5 years later, whereas exercise capacity and pulmonary function abnormalities were associated only with abnormal relaxation 5 years later. After multivariate adjustment, the hazard ratios for the composite endpoint in participants with severe diastolic dysfunction and abnormal relaxation were 4.3 (95% confidence interval: 2.0, 9.3) and 1.6 (95% confidence interval: 1.1, 2.5), respectively. Diastolic dysfunction in young adults is associated with increased morbidity and mortality, and the identification of prospective risk markers associated with diastolic dysfunction could allow for targeted primary prevention efforts.
authors.affiliation: Department of Preventive Medicine, Feinberg School of Medicine, Northwestern University,Chicago, Illinois 60611, USA.
authors.forename: Chintan S
authors.initials: CS
authors.lastname: Desai
authors.forename: Laura A
authors.initials: LA
authors.lastname: Colangelo
authors.forename: Kiang
authors.initials: K
authors.lastname: Liu
authors.forename: David R
authors.initials: DR
authors.lastname: Jacobs
authors.forename: Nakela L
authors.initials: NL
authors.lastname: Cook
authors.forename: Donald M
authors.initials: DM
authors.lastname: Lloyd-Jones
authors.forename: Kofo O
authors.initials: KO
authors.lastname: Ogunyankin
mesh_terms: D000328:Adult; D001741:Black or African American; D015415:Biomarkers; D001794:Blood Pressure; D015992:Body Mass Index; D001837:Body Weights and Measures; D003324:Coronary Artery Disease / Q000453:epidemiology* / Q000401:mortality; D004452:Echocardiography; D004562:Electrocardiography; D005080:Exercise Test; D005260:Female; D015438:Health Behavior; D006333:Heart Failure / Q000401:mortality; D006801:Humans; D008055:Lipids / Q000097:blood; D008297:Male; D009203:Myocardial Infarction / Q000401:mortality; D015995:Prevalence; D011379:Prognosis; D012129:Respiratory Function Tests; D012307:Risk Factors; D020521:Stroke / Q000401:mortality; D013997:Time Factors; D018487:Ventricular Dysfunction, Left / Q000453:epidemiology* / Q000401:mortality / Q000503:physiopathology*; D044465:White People
chemical_list: D015415:Biomarkers; D008055:Lipids