Abstract 18333: Left Ventricular Systolic and Diastolic Dysfunction is an Uncommon Finding in a Pre-modern Society With High Inflammation and Low Atherosclerotic Risk Factors

Abstract

Introduction: Ischemic cardiomyopathy from coronary atherosclerosis is the leading cause of mortality in developed nations. However, the natural history of cardiovascular disease in contemporary pre-industrial man is not well described. The Tsimane of Bolivia are a forager-horticulturalist population in the western Amazonian basin with high levels of inflammation and a low prevalence of atherosclerosis risk factors. We sought to define the cardiovascular health of a contemporary pre-industrial population with high inflammation and low atherosclerotic risk factors. Methods: Two-Dimensional echocardiograms with Color and Doppler were obtained on 934 Tsimane over age 40. Echocardiograms were reviewed by 2 cardiologists following the American Society of Echocardiography guidelines for interpretation. Patients had baseline clinical evaluations including age, height, weight, blood pressure, and gender. Blood was obtained for serology for inflammatory markers. Results: The average age was 53 years (SD +/- 11; range 40-90 years). 455 (48.7%) were male. The prevalences of hypertension, diabetes, and smoking were 4.8%, 0.5%, and 1.3%, respectively. Mean LVEF was 66% (SD +/- 6.1). There were 4 males with LVEF less than 52% and 11 females with LVEF less than 54%. There was no measured LVEF less than 44%. Complete diastolic data was available in 910. Normal diastolic parameters were observed in 741 (81.4%). Mild diastolic dysfunction was found in 167 (18.3%) and moderate dysfunction in 2 (0.2%). No echocardiograms showed severe diastolic dysfunction. Serologic data showed elevated CRP, ESR, and IL-6 with low high density lipoprotein (HDL) and low density lipoprotein (LDL) Conclusions: In a pre-modern population with high inflammation and low atherosclerotic risk factors, cardiovascular systolic and diastolic dysfunction was a rare finding.