Abstract 19023: Left Ventricle Diastolic Dysfunction With Preserved Ejection Fraction, Who is at Higher Risk?

Abstract

Background: Prevalence of left ventricular diastolic dysfunction (LVDD) in a multi ethnic population and the associated risk factors have not been well studied. To risk stratify patients with LVDD, demographics should be further analyzed in a population representative of the nation’s diversity. We aimed to investigate how race and age correlate with the presence and severity of LVDD in a multi-ethnic population. Methods: In a cross-sectional study, we reviewed the medical records of 2702 randomly selected patients who presented to the echocardiographic lab in a tertiary care academic center between 2008 and 2011. Diastolic function was evaluated based on echocardiographic characteristics. Demographic information (including self-reported race) and co-morbid clinical conditions were compared between patients with normal diastolic function and those with LVDD. Mixed races were excluded from the analysis. Using logistic regression, we conducted a multivariate analysis to examine the association of demographic variables with presence and severity of LVDD, after adjusting for co-morbid clinical conditions. Results: The study population included 2702 patients: average (SD) age of 60.3 (16.2), 1853 (68.6%) with LVDD, 1301 (48.4%) females and 848 (31.4%) African-Americans (AA). AAs constituted 213 (25.1%) of patients with normal diastolic function, compared to 660 (35.6%) patients with LVDD (OR: 1.6, 95%CI: 1.2, 2.1, p<0.0001). Multivariable analysis indicated that older age (p<0.0001) and AA race (p=0.0031) are independent correlates of LVDD, after adjusting for potential clinical confounders such as body mass index, high blood pressure, chronic kidney disease, coronary artery disease, diabetes mellitus, right ventricular systolic pressure and other co morbid conditions. AA patients were also found to have a higher likelihood of more severe stages of diastolic dysfunction when compared to other ethnic groups, after adjusting for age and co-morbid conditions. However, patient gender was not associated with presence or severity of LVDD. Conclusion: Older age and African-American ethnicity increases the risk and severity of LVDD, regardless of clinical co-morbid conditions.