Clinical InvestigationCongestive Heart FailureRace/ethnic disparities in left ventricular diastolic function in a triethnic community cohort
Section snippets
Study population
The study cohort was derived from the Northern Manhattan Study (NOMAS), an epidemiologic study evaluating the incidence and risk factors for stroke in the population of Northern Manhattan. The study design and recruitment details regarding NOMAS have been described previously.25 From September 2005 through December 2008, NOMAS subjects >50 years old that voluntarily agreed to undergo a brain magnetic resonance imaging study and a more extensive echocardiographic evaluation including diastolic
Population characteristics
The characteristics of the study cohort (N = 760) are shown in Table I. Mean age was 70.8 ± 9.6 years, and 479 (63.0%) were women. Pairwise comparisons among the race-ethnic groups are also shown in Table I. Hispanics were significantly younger than blacks and whites (both Ps < .0001), and whites had significantly lower body mass index than Hispanics and blacks (P < .05 and P < .0001). Among cardiovascular risk factors, hypertension was significantly more prevalent in blacks than in whites
Discussion
The present study is the first to investigate differences in diastolic function among race-ethnic groups in an unselected community-based cohort. We showed that, after adjusting for age and sex, blacks and Hispanics had worse diastolic function than whites. Hispanics showed lower transmitral E/A ratio, lower E′ velocity, and higher E/E′ ratio compared with whites, whereas blacks showed significantly lower E′ septal velocity, a trend toward higher E/E′ ratio, but no differences in the E/A ratio
Disclosures
The study was supported by grants from the National Institute of Neurological Disorders and Stroke (NINDS)R01 NS36286 (PI: Dr Marco R. Di Tullio) and NS29993 (PIs: Drs Ralph L. Sacco/Mitchell S. V. Elkind).
Acknowledgements
We wish to thank Janet De Rosa, MPH, for the coordination of the study activities; Rui Liu, MD, and Michele Alegre, RDCS, for the performance and preliminary interpretation of the echocardiographic studies; and Rafi Cabral, MD, and Palma Gervasi-Franklin for their help in the collection and management of the data.
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Race- and Gender-Based Differences in Cardiac Structure and Function and Risk of Heart Failure
2022, Journal of the American College of CardiologyCitation Excerpt :These findings extend to late-life previous studies reporting lower LVEF in men regardless of age and other cardiovascular risk factors,12,26 and lowest GLS among Black men among gender-race groups.12,43 In contrast, although Black men display worse LV diastolic function (higher E/A ratio and lower TDI e′) compared with White men and women and Black women in mid-life,12 we did not observe consistent gender- or race-based differences in LV diastolic measures in late life, consistent with one other study in an older population.44 Multiple studies have reported higher HF incidence among Black Americans compared with White Americans in young adulthood and mid-life.3,4
Bending Primordial Trajectories Away From Heart Failure
2021, Journal of the American Society of EchocardiographyLeft Ventricular Diastolic Function in Healthy Adult Individuals: Results of the World Alliance Societies of Echocardiography Normal Values Study
2020, Journal of the American Society of EchocardiographyCitation Excerpt :Chahal et al.20 examined the differences of LV geometry and function between healthy European whites and Indian Asians living in London, reporting that Asians had significantly lower e' velocity and higher E/e' than whites with similar E velocity and E/A.20 LaBounty et al.22 reported that Asians, Hispanics, and whites had similar e' velocities, but blacks had lower e' and higher E/e' than whites in the population living in Michigan.22 Although some community-based studies also examined race-related differences in LV diastolic function, the findings were different.28,29 The reason for these differences can be explained by heterogeneity of the study population.
Effect of Race on Echocardiographic Measures of Cardiac Structure and Function
2019, American Journal of CardiologyComparing the influence of 2009 versus 2016 ASE/EACVI diastolic function guidelines on the prevalence and echocardiographic characteristics of preclinical diastolic dysfunction (stage B heart failure) in a Hispanic population with type 2 diabetes mellitus
2019, Journal of Diabetes and its ComplicationsCitation Excerpt :Adapted 2009 diastolic criteria were used in that study. Similarly, Russo et al. compared diastolic function in different racial-ethnic groups, with increased prevalence of diastolic dysfunction among Hispanics and Blacks, although the authors concluded that many of these differences may be related to sociodemographic factors.28 While the purpose of the 2016 diastolic function guidelines was to simplify the identification of diastolic dysfunction via noninvasive assessment, it is essential both for clinical practice and future cardiovascular research that there is a consistent and reproducible set of criteria for diastolic function that also correlates with long term outcomes.
Differences in left ventricular geometry in hypertensive African-Europeans and Caucasian patients
2019, European Journal of Internal MedicineCitation Excerpt :There are contradictory data regarding the LVMi of African-Americans and African-Europeans compared with Caucasians. Both Dallas Heart Study and CARDIA reported that African-Americans had increased LVMi compared to Caucasians, while no differences were reported in other studies [14,31,32]. Regarding the African-Caribbeans from SABRE Study, it was reported that three-dimensional left ventricular mass was similar between Africans and Caucasians, while conventional two-dimensional LVMi was significantly higher in African-Caribbeans, concluding that three-dimensional echocardiography might be more accurate for assessing LVMi because of less geometric assumptions [30].