Cardiovascular Ultrasound (Mar 2012)

Prevalence of left ventricular diastolic dysfunction in European populations based on cross-validated diagnostic thresholds

  • Kloch-Badelek Malgorzata,
  • Kuznetsova Tatiana,
  • Sakiewicz Wojciech,
  • Tikhonoff Valérie,
  • Ryabikov Andrew,
  • González Arantxa,
  • López Begoña,
  • Thijs Lutgarde,
  • Jin Yu,
  • Malyutina Sofia,
  • Stolarz-Skrzypek Katarzyna,
  • Casiglia Edoardo,
  • Díez Javier,
  • Narkiewicz Krzysztof,
  • Kawecka-Jaszcz Kalina,
  • Staessen Jan A

DOI
https://doi.org/10.1186/1476-7120-10-10
Journal volume & issue
Vol. 10, no. 1
p. 10

Abstract

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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%.

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