Prevalence of Left Ventricular Diastolic Dysfunction in a General Population

Kuznetsova, Tatiana; Herbots, Lieven; López, Begoña; Jin, Yu; Richart, Tom; Thijs, Lutgarde; González, Arantxa; Herregods, Marie‐Christine; Fagard, Robert; Díez, Javier; Staessen, Jan A.

doi:10.1161/circheartfailure.108.822627

Cited by 293 publications

(341 citation statements)

References 23 publications

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“…The data, analytic methods, and study materials will not be made available to other researchers for purposes of reproducing the results or replicating the procedure, because informed consent did not cover this option. Recruitment started in 1985 and continued until 2004 4, 6, 15. The initial participation rate was 78.0%.…”

Section: Methodsmentioning

confidence: 99%

“…Previous publications describe the procedures applied for acquisition and the off‐line analysis of the echocardiographic measurements in detail 4, 6. In short, digitally stored echocardiographic images, obtained with a Vivid7 Pro (GE Vingmed, Horten, Norway) interfaced with a 2.5‐ to 3.5‐MHz phased‐array probe, were averaged over 3 heart cycles.…”

Section: Methodsmentioning

confidence: 99%

“…As described before,4, 6 covariables in the multivariable‐adjusted analyses included sex, the baseline characteristics age, body mass index, heart rate, serum total cholesterol, plasma glucose, γ‐glutamyltransferase (index of alcohol intake)28 and smoking, use of lipid‐lowering treatment at follow‐up, 3 indicator variables coding for starting, stopping, or continuing antihypertensive drug treatment from baseline to follow‐up, and duration of follow‐up. We computed the variance inflation factor from regression models that included both conventional and daytime blood pressure 29.…”

Section: Methodsmentioning

confidence: 99%

“…Subclinical diastolic left ventricular (LV) dysfunction has a prevalence of 25% in the general population,4, 5 predisposes to further deterioration of LV function,6 and finally evolves to overt HF 2. Raised blood pressure is the major risk factor associated cross‐sectionally4, 5, 7 and prospectively6, 8, 9, 10 with diastolic LV dysfunction in the general population. Most studies making this point relied on conventional office blood pressure.…”

mentioning

confidence: 99%

“…To address these knowledge gaps, we analyzed the database of the FLEMENGHO (Flemish Study on Environment, Genes and Health Outcomes) 4, 6, 15. We assessed to what extent office compared with ambulatory blood pressure predicted over a 10‐year span multiple echocardiographic indexes capturing diastolic LV function, first in all people combined, and next in participants categorized according to the guideline‐endorsed operational thresholds of their baseline office and ambulatory blood pressure.…”

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confidence: 99%

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Conventional and Ambulatory Blood Pressure as Predictors of Diastolic Left Ventricular Function in a Flemish Population

Wei

Yang

Thijs

et al. 2018

JAHA

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BackgroundNo longitudinal study compared associations of echocardiographic indexes of diastolic left ventricular function studies with conventional (CBP) and daytime ambulatory (ABP) blood pressure in the general population.Methods and ResultsIn 780 Flemish (mean age, 50.2 years; 51.7% women), we measured left atrial volume index (LAVI), peak velocities of the transmitral blood flow (E) and mitral annular movement (e′) in early diastole and E/e′ 9.6 years (median) after CBP and ABP. In adjusted models including CBP and ABP, we expressed associations per 10/5‐mm Hg systolic/diastolic blood pressure increments. LAVI and E/e′ were 0.65/0.40 mL/m2 and 0.17/0.09 greater with higher systolic/diastolic ABP (P≤0.028), but not with higher baseline CBP (P≥0.086). e′ was lower (P≤0.032) with higher diastolic CBP (−0.09 cm/s) and ABP (−0.19 cm/s). When we substituted baseline CBP by CBP recorded concurrently with echocardiography, LAVI and E/e′ remained 0.45/0.38 mL/m2 and 0.15/0.08 greater with baseline ABP (P≤0.036), while LAVI (+0.53 mL/m2) and E/e′ (+0.19) were also greater (P<0.001) in relation to concurrent systolic CBP. In categorized analyses of baseline data, sustained hypertension or masked hypertension compared with normotension or white‐coat hypertension was associated with greater LAVI (24.0 versus 22.6 mL/m2) and E/e′ (7.35 versus 6.91) and lower e′ (10.7 versus 11.6 cm/s; P≤0.006 for all) with no differences (P≥0.092) between normotension and white‐coat hypertension or between masked hypertension and sustained hypertension.Conclusions ABP is a long‐term predictor of diastolic left ventricular function, statistically outperforming distant but not concurrent CBP. Masked hypertension and sustained hypertension carry equal risk for deterioration of diastolic left ventricular function.

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Section: Methodsmentioning

confidence: 99%

Section: Methodsmentioning

confidence: 99%

Section: Methodsmentioning

confidence: 99%

mentioning

confidence: 99%

mentioning

confidence: 99%

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Conventional and Ambulatory Blood Pressure as Predictors of Diastolic Left Ventricular Function in a Flemish Population

Wei

Yang

Thijs

et al. 2018

JAHA

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Effect of Personalized Accelerated Pacing on Quality of Life, Physical Activity, and Atrial Fibrillation in Patients With Preclinical and Overt Heart Failure With Preserved Ejection Fraction

et al. 2023

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ImportancePatients with heart failure with preserved ejection fraction (HFpEF) with a pacemaker may benefit from a higher, more physiologic backup heart rate than the nominal 60 beats per minute (bpm) setting.ObjectiveTo assess the effects of a moderately accelerated personalized backup heart rate compared with 60 bpm (usual care) in patients with preexisting pacemaker systems that limit pacemaker-mediated dyssynchrony.Design, Setting, and ParticipantsThis blinded randomized clinical trial enrolled patients with stage B and C HFpEF from the University of Vermont Medical Center pacemaker clinic between June 2019 and November 2020. Analysis was modified intention to treat.InterventionsParticipants were randomly assigned to personalized accelerated pacing or usual care and were followed up for 1 year. The personalized accelerated pacing heart rate was calculated using a resting heart rate algorithm based on height and modified by ejection fraction.Main Outcomes and MeasuresThe primary outcome was the serial change in Minnesota Living with Heart Failure Questionnaire (MLHFQ) score. Secondary end points were changes in N-terminal pro–brain natriuretic peptide (NT-proBNP) levels, pacemaker-detected physical activity, atrial fibrillation from baseline, and adverse clinical events.ResultsOverall, 107 participants were randomly assigned to the personalized accelerated pacing (n = 50) or usual care (n = 57) groups. The median (IQR) age was 75 (69-81) years, and 48 (48%) were female. Over 1-year follow-up, the median (IQR) pacemaker-detected heart rate was 75 (75-80) bpm in the personalized accelerated pacing arm and 65 (63-68) bpm in usual care. MLHFQ scores improved in the personalized accelerated pacing group (median [IQR] baseline MLHFQ score, 26 [8-45]; at 1 month, 15 [2-25]; at 1 year, 9 [4-21]; P &lt; .001) and worsened with usual care (median [IQR] baseline MLHFQ score, 19 [6-42]; at 1 month, 23 [5-39]; at 1 year, 27 [7-52]; P = .03). In addition, personalized accelerated pacing led to improved changes in NT-proBNP levels (mean [SD] decrease of 109 [498] pg/dL vs increase of 128 [537] pg/dL with usual care; P = .02), activity levels (mean [SD], +47 [67] minutes per day vs −22 [35] minutes per day with usual care; P &lt; .001), and device-detected atrial fibrillation (27% relative risk reduction compared with usual care; P = .04) over 1-year of follow-up. Adverse clinical events occurred in 4 patients in the personalized accelerated pacing group and 11 patients in usual care.Conclusions and RelevanceIn this study, among patients with HFpEF and pacemakers, treatment with a moderately accelerated, personalized pacing rate was safe and improved quality of life, NT-proBNP levels, physical activity, and atrial fibrillation compared with the usual 60 bpm setting.Trial RegistrationClinicalTrials.gov Identifier: NCT04721314

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Assessment of Systolic and Diastolic Function in Asymptomatic Subjects Using Ambulatory Monitoring With Acoustic Cardiography

Dillier

Züber

Arand

et al. 2011

Clinical Cardiology

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Background: Adequately recording diastolic heart sounds and systolic time intervals over longer periods is difficult. Thus, information on the circadian variation of these parameters in an ambulatory population is lacking. Moreover, age-related changes in the prevalence of diastolic heart sounds and measurements of systolic time intervals in an asymptomatic population have not been studied in continuous recordings. Hypothesis: Diastolic heart sounds and systolic time intervals will have age and circadian variations that reflect known changes in cardiac function due to aging and circadian rhythms. Methods: We studied 128 asymptomatic subjects wearing an ambulatory monitor with acoustic cardiography. The recording spanned a mean duration of 14 hours, including sleep. Data were analyzed for the presence of third (S 3 ) and fourth (S 4 ) heart sounds and for systolic time intervals. Results: In these asymptomatic subjects, S 3 was significantly more prevalent in those age <40 years than in those age >40 years, and significantly more pronounced during sleep in the younger group. Also, S 4 was significantly more prevalent in those age >40 years and significantly more pronounced during sleep in those age >40 years. In contrast, time intervals reflecting systolic function showed less circadian variation and less worsening with age. Conclusions: The nocturnal increase of S 4 in the elderly reflects diastolic impairment-likely a result of changes in diastolic filling patterns with increasing age. An S 3 after the age of 40 is a relatively uncommon finding and therefore should be a specific sign of cardiac disease. Continuous monitoring of diastolic heart sounds and systolic time intervals is possible using acoustic cardiography.

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Prevalence of Left Ventricular Diastolic Dysfunction in a General Population

Cited by 293 publications

References 23 publications

Conventional and Ambulatory Blood Pressure as Predictors of Diastolic Left Ventricular Function in a Flemish Population

Conventional and Ambulatory Blood Pressure as Predictors of Diastolic Left Ventricular Function in a Flemish Population

Effect of Personalized Accelerated Pacing on Quality of Life, Physical Activity, and Atrial Fibrillation in Patients With Preclinical and Overt Heart Failure With Preserved Ejection Fraction

Assessment of Systolic and Diastolic Function in Asymptomatic Subjects Using Ambulatory Monitoring With Acoustic Cardiography

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