Distribution and determinants of Doppler-derived diastolic flow indices in African Americans: the Jackson Heart Study (JHS)

Am Heart J. 2009 Aug;158(2):209-16. doi: 10.1016/j.ahj.2009.05.020.

Abstract

Objectives: The objective of this study is to investigate the distribution and determinants of diastolic function in a middle-aged cohort of African Americans (AA).

Background: The distribution and determinants of left ventricular (LV) diastolic function in AA are not well-described despite high rates of AA with diastolic heart failure and a five-fold higher risk of death in those with diastolic dysfunction (DD) compared to normal diastolic function.

Methods: Four categories of diastolic function were defined in JHS participants undergoing echocardiograms at the first examination (2001-2004) using mitral and pulmonary vein velocities. Investigators used logistic regression to assess the independent relation of DD to traditional risk factors and LV systolic dysfunction.

Results: Of the 3,571 study participants (mean age, 56 +/- 12 years; 63.9% female), 70.4% had normal diastolic function, and 18.0%, 10.6%, and 0.9% had mild, moderate, and severe DD, respectively. In the multivariable analysis, DD was significantly related to age (OR 1.2, 95% CI 1.1-1.4), male sex (OR 1.3 CI 1.0-1.5), LV systolic dysfunction (OR 1.5, CI 1.2-2.0), body mass index (OR 0.8, CI 0.8-0.9), and heart rate (OR 1.2; CI 1.1-1.2). The severity of DD was significantly related with age (OR 0.3; CI 0.3, 0.4), male sex (OR 1.6; CI 1.2-2.2), hypertension (OR 0.6, CI 0.4-0.8), and heart rate (OR 0.7; CI 0.6-0.8).

Conclusion: This is the largest community-based analysis of LV diastolic function in middle-aged AA. DD was present in 29.5% and independently related to several traditional risk factors and LV systolic dysfunction.

MeSH terms

  • Black or African American*
  • Body Mass Index
  • Diabetes Mellitus / ethnology
  • Diabetes Mellitus / physiopathology
  • Diabetic Angiopathies / diagnostic imaging
  • Diabetic Angiopathies / ethnology
  • Diabetic Angiopathies / physiopathology
  • Diastole / physiology*
  • Echocardiography, Doppler*
  • Female
  • Humans
  • Male
  • Multivariate Analysis
  • Prevalence
  • Risk Factors
  • Systole / physiology
  • Ventricular Dysfunction, Left / diagnostic imaging
  • Ventricular Dysfunction, Left / ethnology
  • Ventricular Dysfunction, Left / physiopathology
  • Ventricular Function, Left / physiology*