Siu-Hin Wan1, Andrew S Pumerantz2, Fanglong Dong3, Cesar Ochoa4, Horng H Chen5. 1. Department of Cardiovascular Diseases, Mayo Clinic, Rochester, MN, USA. 2. Western Diabetes Institute, Western University of Health Sciences, Pomona, CA, USA; Department of Population Health, College of Osteopathic Medicine of the Pacific, Western University of Health Sciences, Pomona, CA, USA. 3. Graduate College of Biomedical Sciences, Western University of Health Sciences, Pomona, CA, USA. 4. Western Diabetes Institute, Western University of Health Sciences, Pomona, CA, USA. 5. Department of Cardiovascular Diseases, Mayo Clinic, Rochester, MN, USA. Electronic address: chen.horng@mayo.edu.
Abstract
AIMS: To identify prevalence and predictors of undetected pre-clinical diastolic dysfunction (PDD) in a cohort of adult Hispanic patients with type 2 diabetes (T2D), and compare variations in epidemiology and echocardiographic characteristics between categorization based on the 2009 versus 2016 guidelines. METHODS: From 2013 to 2016, a cross-sectional cohort study of adults with T2D was performed. Patients without signs/symptoms of heart failure (HF) underwent 2D/Doppler echocardiographic screening, and were grouped into two subcohorts: 1) normal diastolic function, and 2) PDD, defined by the 2009 or 2016 ASE/EACVI criteria. RESULTS: Among 307 Hispanic subjects, by 2009 criteria, 193 (62.9%) had normal diastolic function, 113 (36.8%) diastolic dysfunction and 1 (0.3%) indeterminate. Those that had diastolic dysfunction (DD) were older (mean age 59.1 ± 12.7 vs 52.2 ± 12.2 years, p< 0.0001), with higher proportion female (69.0 vs 53.9%, p = 0.0092), and higher systolic blood pressure (136.5 ± 18.6 vs 131.7 ± 19.9, p = 0.0372). By 2016 criteria, 261 (85%) had normal diastolic function, 22 (7.2%) diastolic dysfunction and 24 (7.8%) indeterminate. Among those that had normal diastolic function (n = 261) by 2016 criteria, 29% (n = 76) had DD by 2009 criteria, and they were more likely to have higher E/e' and left atrial volume index (LAVI). CONCLUSIONS: By applying the 2016 versus the 2009 diastolic function criteria to a Hispanic population with T2D, the prevalence of PDD decreased significantly from 37% to 7%. These findings are consistent with recent studies demonstrating that the 2016 ASE/EACVI guidelines are more specific for diagnosing DD and hence less sensitive leading to lower prevalence of diastolic dysfunction.
AIMS: To identify prevalence and predictors of undetected pre-clinical diastolic dysfunction (PDD) in a cohort of adult Hispanic patients with type 2 diabetes (T2D), and compare variations in epidemiology and echocardiographic characteristics between categorization based on the 2009 versus 2016 guidelines. METHODS: From 2013 to 2016, a cross-sectional cohort study of adults with T2D was performed. Patients without signs/symptoms of heart failure (HF) underwent 2D/Doppler echocardiographic screening, and were grouped into two subcohorts: 1) normal diastolic function, and 2) PDD, defined by the 2009 or 2016 ASE/EACVI criteria. RESULTS: Among 307 Hispanic subjects, by 2009 criteria, 193 (62.9%) had normal diastolic function, 113 (36.8%) diastolic dysfunction and 1 (0.3%) indeterminate. Those that had diastolic dysfunction (DD) were older (mean age 59.1 ± 12.7 vs 52.2 ± 12.2 years, p< 0.0001), with higher proportion female (69.0 vs 53.9%, p = 0.0092), and higher systolic blood pressure (136.5 ± 18.6 vs 131.7 ± 19.9, p = 0.0372). By 2016 criteria, 261 (85%) had normal diastolic function, 22 (7.2%) diastolic dysfunction and 24 (7.8%) indeterminate. Among those that had normal diastolic function (n = 261) by 2016 criteria, 29% (n = 76) had DD by 2009 criteria, and they were more likely to have higher E/e' and left atrial volume index (LAVI). CONCLUSIONS: By applying the 2016 versus the 2009 diastolic function criteria to a Hispanic population with T2D, the prevalence of PDD decreased significantly from 37% to 7%. These findings are consistent with recent studies demonstrating that the 2016 ASE/EACVI guidelines are more specific for diagnosing DD and hence less sensitive leading to lower prevalence of diastolic dysfunction.
Authors: Cesare Russo; Zhezhen Jin; Shunichi Homma; Tatjana Rundek; Mitchell S V Elkind; Ralph L Sacco; Marco R Di Tullio Journal: Am Heart J Date: 2010-07 Impact factor: 4.749
Authors: Sherif F Nagueh; Otto A Smiseth; Christopher P Appleton; Benjamin F Byrd; Hisham Dokainish; Thor Edvardsen; Frank A Flachskampf; Thierry C Gillebert; Allan L Klein; Patrizio Lancellotti; Paolo Marino; Jae K Oh; Bogdan Alexandru Popescu; Alan D Waggoner Journal: J Am Soc Echocardiogr Date: 2016-04 Impact factor: 5.251
Authors: Mark Ledwidge; Joseph Gallagher; Carmel Conlon; Elaine Tallon; Eoin O'Connell; Ian Dawkins; Chris Watson; Rory O'Hanlon; Margaret Bermingham; Anil Patle; Mallikarjuna R Badabhagni; Gillian Murtagh; Victor Voon; Leslie Tilson; Michael Barry; Laura McDonald; Brian Maurer; Kenneth McDonald Journal: JAMA Date: 2013-07-03 Impact factor: 56.272
Authors: R B Devereux; M J Roman; M Paranicas; M J O'Grady; E T Lee; T K Welty; R R Fabsitz; D Robbins; E R Rhoades; B V Howard Journal: Circulation Date: 2000-05-16 Impact factor: 29.690
Authors: Christian Bommer; Esther Heesemann; Vera Sagalova; Jennifer Manne-Goehler; Rifat Atun; Till Bärnighausen; Sebastian Vollmer Journal: Lancet Diabetes Endocrinol Date: 2017-04-26 Impact factor: 32.069
Authors: Sanjay Dandamudi; Joshua Slusser; Douglas W Mahoney; Margaret M Redfield; Richard J Rodeheffer; Horng H Chen Journal: J Card Fail Date: 2014-02-24 Impact factor: 5.712
Authors: Teresa S M Tsang; Walter P Abhayaratna; Marion E Barnes; Yoko Miyasaka; Bernard J Gersh; Kent R Bailey; Stephen S Cha; James B Seward Journal: J Am Coll Cardiol Date: 2006-02-09 Impact factor: 24.094
Authors: Paul Z Zimmet; Dianna J Magliano; William H Herman; Jonathan E Shaw Journal: Lancet Diabetes Endocrinol Date: 2013-12-03 Impact factor: 32.069