title: Longitudinal changes in left ventricular diastolic function in a general population.
abstract: BACKGROUND
  Data on changes in left ventricular diastolic function (LVDF) over time in the general population are sparse. We, therefore, investigated in the population cohort clinical correlates of longitudinal changes in Doppler diastolic indexes analyzed as continuous measures and assessed factors predictive of the changes in LVDF grades over time.
  
  
  RESULTS
  We measured early and late diastolic peak velocities of mitral inflow (E and A) by conventional Doppler, and the mitral annular velocities (e' and a') by tissue Doppler imaging in 650 participants (mean age, 50.7 years) at baseline and after 4.7 years (5th to 95th percentile, 3.7-5.4). In stepwise regression, the multivariable-adjusted correlates of the change in the transmitral and tissue Doppler imaging diastolic indexes included sex, age, baseline serum insulin, blood pressure, and heart rate. During follow-up, LVDF grades remained unchanged in 87.2% (95% confidence interval, 84.6%-89.8%), improved in 3.7% (95% confidence interval, 2.25%-5.15%), and worsened in 9.1% (95% confidence interval, 6.9%-11.3%). Baseline age was a strong predictor of worsening of LVDF from normal/mild grade to more advanced grade (odds ratio, 3.22; P<0.0001). A doubling of baseline insulin was associated with a 184% increase in the odds of worsening of LVDF (P<0.0001). Moreover, baseline diastolic blood pressure and the change in systolic blood pressure over time predicted worsening of LVDF (P≤0.014).
  
  
  CONCLUSIONS
  The key findings of this study are that LVDF tended to worsen over time and was associated with advanced age, higher baseline insulin level, and hemodynamic parameters, such as heart rate and blood pressure.
authors: From the Research Unit Hypertension and Cardiovascular Epidemiology, KU Leuven Department of Cardiovascular Sciences, University of Leuven, Leuven, Belgium (T.K., L.T., J.K., N.C., T.P., Y-M.G., Z.Z., J.A.S.). tatiana.kouznetsova@med.kuleuven.be.
authors: Tatiana
authors: T
authors: Kuznetsova
authors: From the Research Unit Hypertension and Cardiovascular Epidemiology, KU Leuven Department of Cardiovascular Sciences, University of Leuven, Leuven, Belgium (T.K., L.T., J.K., N.C., T.P., Y-M.G., Z.Z., J.A.S.).
authors: Lutgarde
authors: L
authors: Thijs
authors: From the Research Unit Hypertension and Cardiovascular Epidemiology, KU Leuven Department of Cardiovascular Sciences, University of Leuven, Leuven, Belgium (T.K., L.T., J.K., N.C., T.P., Y-M.G., Z.Z., J.A.S.).
authors: Judita
authors: J
authors: Knez
authors: From the Research Unit Hypertension and Cardiovascular Epidemiology, KU Leuven Department of Cardiovascular Sciences, University of Leuven, Leuven, Belgium (T.K., L.T., J.K., N.C., T.P., Y-M.G., Z.Z., J.A.S.).
authors: Nicholas
authors: N
authors: Cauwenberghs
authors: From the Research Unit Hypertension and Cardiovascular Epidemiology, KU Leuven Department of Cardiovascular Sciences, University of Leuven, Leuven, Belgium (T.K., L.T., J.K., N.C., T.P., Y-M.G., Z.Z., J.A.S.).
authors: Thibault
authors: T
authors: Petit
authors: From the Research Unit Hypertension and Cardiovascular Epidemiology, KU Leuven Department of Cardiovascular Sciences, University of Leuven, Leuven, Belgium (T.K., L.T., J.K., N.C., T.P., Y-M.G., Z.Z., J.A.S.).
authors: Yu-Mei
authors: YM
authors: Gu
authors: From the Research Unit Hypertension and Cardiovascular Epidemiology, KU Leuven Department of Cardiovascular Sciences, University of Leuven, Leuven, Belgium (T.K., L.T., J.K., N.C., T.P., Y-M.G., Z.Z., J.A.S.).
authors: Zhenyu
authors: Z
authors: Zhang
authors: From the Research Unit Hypertension and Cardiovascular Epidemiology, KU Leuven Department of Cardiovascular Sciences, University of Leuven, Leuven, Belgium (T.K., L.T., J.K., N.C., T.P., Y-M.G., Z.Z., J.A.S.).
authors: Jan A
authors: JA
authors: Staessen
mesh_terms: D000328:Adult; D000367:Age Factors; D000368:Aged; D003971:Diastole / Q000502:physiology; D015150:Echocardiography, Doppler; D005260:Female; D006439:Hemodynamics; D006801:Humans; D007328:Insulin / Q000097:blood; D008137:Longitudinal Studies; D008297:Male; D008875:Middle Aged; D012016:Reference Values; D018487:Ventricular Dysfunction, Left / Q000453:epidemiology / Q000503:physiopathology; D016277:Ventricular Function, Left
chemical_list: D007328:Insulin
keywords: Doppler echocardiography; epidemiology; left ventricular function; longitudinal survey