Prevalence of Diastolic Left Ventricular Dysfunction in European Populations Based on Cross-Validated Diagnostic Thresholds

Kloch−Badełek, Małgorzata; Kuznetsova, Tatiana; Sakiewicz, W.; Tikhonoff, Valérie; Ryabikov, A.; González, Alejandro; Thijs, Lutgarde; Jin, Yu; Malyutina, S.; Stolarz‐Skrzypek, Katarzyna; Casíglia, Edoardo; Díez, José; Kawecka‐Jaszcz, K.; Staessen, Jan A.

doi:10.1097/00004872-201106001-01575

Cited by 12 publications

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“…[3][4][5][6] For instance, in the Flemish Study on Environment, Genes, and Health Outcomes (FLEMENGHO), the frequency was 27.3%.…”

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confidence: 99%

“…2 Recent community-based studies revealed a higher than hitherto expected prevalence of LV diastolic dysfunction, using comprehensive conventional and TDI echocardiographic imaging. [3][4][5][6] For instance, in the Flemish Study on Environment, Genes, and Health Outcomes (FLEMENGHO), the frequency was 27.3%. 5 LV diastolic dysfunction is also associated with increased risk for various cardiovascular diseases.…”

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confidence: 99%

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Longitudinal Changes in Left Ventricular Diastolic Function in a General Population

Kuznetsova

Thijs

Knez

et al. 2015

Circ: Cardiovascular Imaging

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Because life expectancy and the prevalence of risk factors, such as hypertension, obesity, insulin resistance and diabetes mellitus are rising globally, heart failure is growing into a major health problem. Impairment of left ventricular diastolic function (LVDF) appears early in the course of heart disease. Recent heart failure guidelines, therefore, place special emphasis on the detection of subclinical LV dysfunction and the timely identification of risk factors for progression to symptomatic heart failure.1 Conventional echocardiography combined with new imaging techniques such as tissue Doppler imaging (TDI) is a sensitive tool to detect early subclinical deterioration of LV function.2 Recent community-based studies revealed a higher than hitherto expected prevalence of LV diastolic dysfunction, using comprehensive conventional and TDI echocardiographic imaging. [3][4][5][6] For instance, in the Flemish Study on Environment, Genes, and Health Outcomes (FLEMENGHO), the frequency was 27.3%.5 LV diastolic dysfunction is also associated with increased risk for various cardiovascular diseases. 4,7,8 See Editorial by Fitzgibbons and Aurigemma See Clinical PerspectiveCommunity-based studies have identified cross-sectionally that age, body mass index, heart rate (HR), and diastolic blood pressure (DBP) are important correlates of echocardiographic LVDF indexes. 5,6 However, data on the longitudinal tracking of LVDF over time are sparse. To our knowledge, 2 community-based studies 9,10 explored the factors predictive of the development of subclinical LV diastolic dysfunction. In the clinical setting, Aljaroudi et al 11 reported that in patients with normal baseline LV ejection fraction, worsening of diastolic function grade was an independent predictor of mortality. However, serial imaging studies are also needed to clarify the clinical correlates of change in LVDF indexes. These data are currently lacking. We, therefore, investigated 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. Methods and 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 ...

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“…[3][4][5][6] For instance, in the Flemish Study on Environment, Genes, and Health Outcomes (FLEMENGHO), the frequency was 27.3%.…”

mentioning

confidence: 99%

mentioning

confidence: 99%

Longitudinal Changes in Left Ventricular Diastolic Function in a General Population

Kuznetsova

Thijs

Knez

et al. 2015

Circ: Cardiovascular Imaging

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“…Ischemia and chronic conditions like diabetes with insulin resistance and increased free fatty acid flux are responsible for an abnormal energy balance in mitochondria and impaired removal of calcium during diastole by the sarcoplasmic/endoplasmic reticulum Ca 2+ ATPase (SERCA2a) pump. In the general population, the prevalence of congestive heart failure (CHF) and LV diastolic dysfunction increases with age [49]. Diastolic heart failure (DHF) accounts for more than 50 % of the heart failure population and is also called heart failure with normal LV ejection fraction (LVEF).…”

Section: Coronary Artery Diseasementioning

confidence: 99%

Cardiovascular Changes during Chronic Hypertensive States

Swathi¹,

Rizwan²

2016

jmscr

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It is well established that elevated blood pressure constitutes a major risk factor for coronary heart disease, arrythmias, heart failure, cerebrovascular disease, peripheral artery disease and renal failure. Blood pressure level and the duration of arterial hypertension (HTN) impact target organ damage. Many studies in adults have demonstrated the role of antihypertensive therapy in preventing cardiovascular (CV) events. The so-called hard end-points, such as death, myocardial infarction (MI) or stroke, are rarely seen in children, but intermediate target organ damage, including left ventricular hypertrophy, increased intima-media thickness and microalbuminuria, is already detectable during childhood. The goal of antihypertensive treatment is to reduce the global risk of CV events. In the adult population stratification of CV risk is based on blood pressure level, risk factors, subclinical target organ damage and established CV and kidney disease. Increased CV risk begins early in the course of kidney disease, and CV diseases are the most frequent cause of morbidity and mortality in patients with chronic kidney disease (CKD). Children with CKD are especially prone to the long-term effects of CV risk factors, which result in high morbidity and mortality in young adults. To improve the outcome, pediatric and adult CKD patients require nephro-and cardioprotection.

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“…Диастолическая дисфункция (ДД) является важным пре-диктором ХСН, и может длительное время протекать бес-симптомно [4]. В общей популяции распространенность симптомной и бессимптомной диастолической дисфункции левого желудочка (ДДЛЖ) достигает 22-25% [5]. Согласно результатам исследования ЭПОХА-О-ХСН среди больных ХСН ДДЛЖ была вы-явлена у 80% пациентов, у 44% -в виде изолиро-ванного нарушения, у 36% сочеталась с систолической дисфункцией [3].…”

Section: влияние противоревматической терапии на диастолическую дисфуunclassified

Effect of «treat-to-Target» Antirheumatic Therapy on Diastolic Dysfunction of the Left and Right Ventricles in Patients With Early Rheumatoid Arthritis During 18 Months of Observation

Kirillova¹,

Новикова²,

Попкова³

et al. 2015

Racionalʹnaâ farmakoterapiâ v kardiologii

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1 Научно-исследовательский институт ревматологии им. В.А. Насоновой 115522, Москва, Каширское шоссе, 34а; 2 Институт клинической кардиологии им. А.Л. Мясникова, Российский кардиологический научно-производственный комплекс, 121552, Москва, ул. 3-я Черепковская, 15аЦель. Изучить влияние противоревматической терапии, проводимой в соответствии с принципом стратегии «treat-to-target», на диастолическую дисфункцию лево-го (ДДЛЖ) и правого (ДДПЖ) желудочков у больных ранним ревматоидным артритом (РА) в течение 18 мес наблюдения. Материал и методы. В исследование включено 66 пациентов (71% женщин, возраст -56 [46;61] лет) с ранним РА (критерии ACR/EULAR, 2010) с умеренной или высокой активностью (DAS28 5,3 [5,0;6,2]), серопозитивными по ревматоидному фактору (77%) и/или антителам к циклическому цитруллинированному пептиду (100%), без опыта приёма базисных противовоспалительных препаратов (БПВП) и глюкокортикоидов. Всем пациентам начата терапия метотрексатом (МТ) с эскалацией дозы до 25-30 мг/нед подкожно. При отсутствии эффекта через 3 мес 47 (71%) пациентам к терапии МТ присоединяли генно-инженерные биологические препа-раты (ГИБП). Через 18 мес 44% больных достигли ремиссии РА. 51 пациент (77%) получал кардиопротективную терапию. Эффективный контроль артериального дав-ления (АД) был достигнут у 38 пациентов (58%). Оценка традиционных факторов риска сердечно-сосудистых заболеваний, суточное мониторирование АД и эхокардиография проведены у всех пациентов с ранним РА до начала терапии и через 18 мес лечения МТ/МТ+ГИБП. Результаты. Через 18 мес наблюдения частота ДДЛЖ снизилась на 7% (с 49% до 42%) (р>0,05), ДДПЖ -на 5% (с 24% до 17%; р>0,05). В группе больных, полу-чавших МТ+ГИБП, отмечалось более выраженное снижение ДДЛЖ [с 23 (62%) до 18 (49%)] и ДДПЖ [с 12 (32%) до 6 (16%)] (р=0,05), чем в группе больных на терапии МТ [частота ДДЛЖ не изменилась -7 (28%), а частота ДДПЖ увеличилась с 3 (12%) до 4 (16%); p>0,05]. У больных ранним РА нормализация диастоличе-ской функции левого желудочка (ЛЖ) зависела преимущественно от эффективности лечения артериальной гипертонии, а правого желудочка (ПЖ) -от достижения целевых уровней АД и ремиссии РА. Снижение скорости оседания эритроцитов (СОЭ) и концентрации С-реактивного белка (СРБ) ассоциировались с улучшением диа-столической функции ЛЖ к 18-му мес наблюдения [Е/А ЛЖ и ΔСОЭ (r=-0,3; р<0,04), Е/А ЛЖ и СРБ (r=-0,2; р<0,05), А ЛЖ и СОЭ (r=0,3; р<0,01)] и ПЖ [ΔА ПЖ и ΔСРБ (r=0,4; р<0,003), ΔЕ ПЖ и ΔСРБ (r=0,3; р<0,01), Е/А ПЖ и DAS28 (r=-0,5; р<0,001), Е/А ПЖ и СРБ (r=-0,3; р<0,05)]. Заключение. У больных ранним РА через 18 мес отмечается тенденция к снижению частоты ДДЛЖ и значимое снижение частоты ДДПЖ, более выраженные на тера-пии МТ+ГИБП. Достижение ремиссии РА и целевых значений АД являются необходимым условием для нормализации диастолической функции ЛЖ и ПЖ и замед-ления прогрессирования хронической сердечной недостаточности. Ключевые слова: ранний ревматоидный артрит, исследование РЕМАРКА, диастолическая дисфункция, хроническая сердечная недостаточность, метотрексат, генно-инж...

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Prevalence of Diastolic Left Ventricular Dysfunction in European Populations Based on Cross-Validated Diagnostic Thresholds

Cited by 12 publications

References 0 publications

Longitudinal Changes in Left Ventricular Diastolic Function in a General Population

Longitudinal Changes in Left Ventricular Diastolic Function in a General Population

Cardiovascular Changes during Chronic Hypertensive States

Effect of «treat-to-Target» Antirheumatic Therapy on Diastolic Dysfunction of the Left and Right Ventricles in Patients With Early Rheumatoid Arthritis During 18 Months of Observation

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