Abstract 19878: Burden of Systolic and Diastolic Left Ventricular Dysfunction Among Hispanics in the United States - Insights From the Echocardiographic Study of Latinos (ECHO-SOL)

Abstract

Introduction: Population-based estimates of cardiac dysfunction and clinical heart failure (HF) remain undefined among Hispanic/Latino adults. Hypothesis: Among Hispanic/Latino adults, prevalence of clinical HF and subclinical cardiac dysfunction is high. Methods: Adult participants of Hispanic/Latino origin were enrolled into the Echocardiographic Study of Latinos (ECHO-SOL). Left ventricular systolic dysfunction (LVSD) was defined as an ejection fraction (EF) less than 50%; left ventricular diastolic dysfunction (LVDD) was defined using the Redfield and American Society of Echocardiography criteria. Baseline diagnosis of clinical HF was defined according to self-report; and those with cardiac dysfunction without clinical HF were characterized as having subclinical or unrecognized cardiac dysfunction. Results: Of the 1818 participants (mean age 56.4 years; 42.6% male) enrolled in ECHO-SOL, 52.7% had some form of cardiac dysfunction. The prevalence of LVSD was 3.6%, while LVDD was detected in 53.5%. Participants with LVSD were more likely to be males and current smokers and have lower socioeconomic status (all p<0.05). Female sex, hypertension, diabetes, higher body-mass index and renal dysfunction were more common among those with LVDD (all p<0.05). LVSD prevalence did not vary by Hispanic/Latino background group; however, in age-sex adjusted models, individuals of Central American and Cuban backgrounds were almost two-fold more likely to have LVDD compared to those of Mexican backgrounds. Prevalence of clinical HF with LVSD was 7.3%; prevalence of clinical HF with LVDD was 3.6%. Among those with cardiac dysfunction, 96.2% of the cardiac dysfunction was subclinical or unrecognized. Among those with cardiac dysfunction, prevalent coronary heart disease was the only factor independently inversely associated with subclinical or unrecognized cardiac dysfunction (odds ratio: 0.14; 95% confidence interval: 0.05-0.38).Conclusion: Among Hispanics/Latinos, most cardiac dysfunction is subclinical or unrecognized, and there is a high prevalence of diastolic dysfunction. This suggests that Hispanics/Latinos are a high-risk population for the development of clinical HF.

Heart Disease and Stroke Statistics—2022 Update: A Report From the American Heart Association

“…51 In the Echocardiographic Study of Latinos, almost half (49.7%) of middle-aged or older Hispanic individuals had some form of cardiac dysfunction (systolic, diastolic, or both); paradoxically, <1 in 20 Hispanic/Latino individuals had symptomatic or clinically recognized HF. 52 …”

Heart Disease and Stroke Statistics—2023 Update: A Report From the American Heart Association

“…In the Echocardiographic Study of Latinos, almost half of middle-aged or older Hispanic individuals had some form of cardiac dysfunction (3.6% systolic, 50.3% diastolic, or both); 96% of cardiac dysfunction was subclinical or unrecognized. 62…”