Progression of left ventricular diastolic dysfunction in ethnic minorities.
BACKGROUND
Approximately 50 % of heart failure cases are due to diastolic failure. Generally, it is thought that asymptomatic diastolic dysfunction precedes the development of diastolic heart failure, representing an ideal time for intervention. Previous studies have examined progression rates in non-minority populations only.


OBJECTIVE
To determine the rate of diastolic dysfunction progression and the associated risk factors in a predominately ethnic minority population.


METHODS
A retrospective cohort study of participants drawn from the echocardiogram database and Electronic Health Record (EHR) for an academic medical center. Individuals with 2 or more echocardiograms showing diastolic dysfunction during a six year study period (2006–2012) were selected.


METHODS
Change in diastolic function grade over time and risk factors associated with this change.


RESULTS
During the six-year retrospective study period, 154 patients with 2 or more echocardiograms demonstrating diastolic dysfunction were reviewed; these represented 496 echocardiograms. The mean time between echocardiograms was 1.9 years. Mean age was 64.6 (±10.1) years,81 % were female, and average BMI was 30.5(±7.4). The majority of subjects had Grade I diastolic dysfunction at the initial examination (87.7 % (n = 135)); 9 % (n = 14) had Grade II, and 3 % (n = 5) had Grade III. Approximately 27.9 % (n = 43) of the study cohort demonstrated overall worsening grade of diastolic dysfunction over time. Diastolic dysfunction grade was unchanged in 62 %(n = 96), improved in 9.7 % (n = 14), and worsened then improved in 0.7 % (n = 1).


CONCLUSIONS
Our study showed a slightly higher rate of diastolic dysfunction progression in this predominately ethnic minority population. This is consistent with a previous study in a non-minority population demonstrating the progressive nature of diastolic dysfunction over time.Understanding the role of cardiovascular disease risk factors in accelerating progression rates from asymptomatic diastolic dysfunction to symptomatic stages is paramount to optimize intervention strategies.
Heather M
HM
Prendergast
Samuel
S
Dudley
John
J
Kane
Martha
M
Daviglus
Jared
J
Marcucci
Anthony
A
Acosta
E Bradshaw
EB
Bunney
Dejuran
D
Richardson
Tamara
T
O'Neal
D001741:Black or African American; D000368:Aged; D001213:Asian; D015331:Cohort Studies; D018450:Disease Progression; D004562:Electrocardiography; D005006:Ethnicity; D005260:Female; D054144:Heart Failure, Diastolic / Q000208:ethnology* / Q000503:physiopathology*; D006630:Hispanic or Latino; D006801:Humans; D007198:Indians, North American; D008297:Male; D008875:Middle Aged; D008913:Minority Groups; D017063:Outcome Assessment, Health Care; D012189:Retrospective Studies; D012307:Risk Factors; D013997:Time Factors; D018487:Ventricular Dysfunction, Left / Q000208:ethnology* / Q000503:physiopathology*