Diastolic function and its association with diabetes, hypertension and age in an outpatient population with normal stress echocardiography findings
Abstract Background Diastolic dysfunction can be caused by hypertension or diabetes mellitus, and it is also often found with increasing age. In a given patient, the cause of diastolic dysfunction is therefore not always obvious. We sought to study the interplay of these risk factors for diastolic d...
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| Format: | Article |
| Language: | English |
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BMC
2020-11-01
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| Series: | Cardiovascular Ultrasound |
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| Online Access: | http://link.springer.com/article/10.1186/s12947-020-00228-9 |
| _version_ | 1819295398417661952 |
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| author | Martin G. Sundqvist Anders Sahlén Zee Pin Ding Martin Ugander |
| author_facet | Martin G. Sundqvist Anders Sahlén Zee Pin Ding Martin Ugander |
| author_sort | Martin G. Sundqvist |
| collection | DOAJ |
| description | Abstract Background Diastolic dysfunction can be caused by hypertension or diabetes mellitus, and it is also often found with increasing age. In a given patient, the cause of diastolic dysfunction is therefore not always obvious. We sought to study the interplay of these risk factors for diastolic dysfunction in an outpatient population with a low likelihood of ischemic heart disease. Methods Consecutive patients referred for stress echocardiography were included retrospectively. Exclusion criteria included pathological stress response, atrial arrhythmia, left ventricular ejection fraction < 55%, and more than mild valvular disease. Standard diastolic parameters were recorded in all patients. In a subset of patients, mechanistic analysis of early filling was performed using the parameterized diastolic filling (PDF) method. Results We included 726 patients (median [interquartile range] age 56 (44–65) years, 57% male). The prevalence of diabetes and hypertension was 43 and 49%, respectively. In multiple linear regression modeling, the presence of diabetes, hypertension, sex and increasing age explained a moderate amount of the variance in e’ velocities, E/A ratio and E/e’ (R2 = 0.31–0.48, p < 0.001), and a low amount of the variance in left atrial volume index (LAVI) and the PDF parameters (n = 446, R2 = 0.05–0.17, p < 0.001). Sex was only related to LAVI and E/e’ for the conventional parameters (beta − 0.94, p = 0.04, and beta − 0.91, p < 0.001, respectively). Conclusions Diabetes, hypertension, increasing age, and to a lesser extent sex, explain a moderate amount of the variance in conventional diastolic parameters related to myocardial tissue velocities and E/A ratio in a healthy outpatient population. The effect of these risk factors was substantially less pronounced on left atrial volume index and the PDF parameters. |
| first_indexed | 2024-12-24T04:41:35Z |
| format | Article |
| id | doaj.art-fcc52f70077c477b88e0924d58c21ea0 |
| institution | Directory Open Access Journal |
| issn | 1476-7120 |
| language | English |
| last_indexed | 2024-12-24T04:41:35Z |
| publishDate | 2020-11-01 |
| publisher | BMC |
| record_format | Article |
| series | Cardiovascular Ultrasound |
| spelling | doaj.art-fcc52f70077c477b88e0924d58c21ea02022-12-21T17:14:48ZengBMCCardiovascular Ultrasound1476-71202020-11-011811710.1186/s12947-020-00228-9Diastolic function and its association with diabetes, hypertension and age in an outpatient population with normal stress echocardiography findingsMartin G. Sundqvist0Anders Sahlén1Zee Pin Ding2Martin Ugander3Department of Clinical Science and Education, Södersjukhuset, Karolinska Institutet, and Department of Cardiology, SödersjukhusetNational Heart CentreNational Heart CentreDepartment of Clinical Physiology, Karolinska University Hospital, and Karolinska InstitutetAbstract Background Diastolic dysfunction can be caused by hypertension or diabetes mellitus, and it is also often found with increasing age. In a given patient, the cause of diastolic dysfunction is therefore not always obvious. We sought to study the interplay of these risk factors for diastolic dysfunction in an outpatient population with a low likelihood of ischemic heart disease. Methods Consecutive patients referred for stress echocardiography were included retrospectively. Exclusion criteria included pathological stress response, atrial arrhythmia, left ventricular ejection fraction < 55%, and more than mild valvular disease. Standard diastolic parameters were recorded in all patients. In a subset of patients, mechanistic analysis of early filling was performed using the parameterized diastolic filling (PDF) method. Results We included 726 patients (median [interquartile range] age 56 (44–65) years, 57% male). The prevalence of diabetes and hypertension was 43 and 49%, respectively. In multiple linear regression modeling, the presence of diabetes, hypertension, sex and increasing age explained a moderate amount of the variance in e’ velocities, E/A ratio and E/e’ (R2 = 0.31–0.48, p < 0.001), and a low amount of the variance in left atrial volume index (LAVI) and the PDF parameters (n = 446, R2 = 0.05–0.17, p < 0.001). Sex was only related to LAVI and E/e’ for the conventional parameters (beta − 0.94, p = 0.04, and beta − 0.91, p < 0.001, respectively). Conclusions Diabetes, hypertension, increasing age, and to a lesser extent sex, explain a moderate amount of the variance in conventional diastolic parameters related to myocardial tissue velocities and E/A ratio in a healthy outpatient population. The effect of these risk factors was substantially less pronounced on left atrial volume index and the PDF parameters.http://link.springer.com/article/10.1186/s12947-020-00228-9EchocardiographyDiastolic functionHypertensionDiabetes mellitusAgeing |
| spellingShingle | Martin G. Sundqvist Anders Sahlén Zee Pin Ding Martin Ugander Diastolic function and its association with diabetes, hypertension and age in an outpatient population with normal stress echocardiography findings Cardiovascular Ultrasound Echocardiography Diastolic function Hypertension Diabetes mellitus Ageing |
| title | Diastolic function and its association with diabetes, hypertension and age in an outpatient population with normal stress echocardiography findings |
| title_full | Diastolic function and its association with diabetes, hypertension and age in an outpatient population with normal stress echocardiography findings |
| title_fullStr | Diastolic function and its association with diabetes, hypertension and age in an outpatient population with normal stress echocardiography findings |
| title_full_unstemmed | Diastolic function and its association with diabetes, hypertension and age in an outpatient population with normal stress echocardiography findings |
| title_short | Diastolic function and its association with diabetes, hypertension and age in an outpatient population with normal stress echocardiography findings |
| title_sort | diastolic function and its association with diabetes hypertension and age in an outpatient population with normal stress echocardiography findings |
| topic | Echocardiography Diastolic function Hypertension Diabetes mellitus Ageing |
| url | http://link.springer.com/article/10.1186/s12947-020-00228-9 |
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