Prevalence of Diastolic Dysfunction Among Consecutive Patients with CVD Risk Factors Referred for Echocardiography

Mady Moriel Jesselson Integrated Heart Center, Shaare Zedek Medical Center, Jerusalem, Israel Adi Butnaru Jesselson Integrated Heart Center, Shaare Zedek Medical Center, Jerusalem, Israel Marc Klutstein Jesselson Integrated Heart Center, Shaare Zedek Medical Center, Jerusalem, Israel Shmuel Gottlieb Jesselson Integrated Heart Center, Shaare Zedek Medical Center, Jerusalem, Israel Feras Bayya Jesselson Integrated Heart Center, Shaare Zedek Medical Center, Jerusalem, Israel Rivka Farkash Jesselson Integrated Heart Center, Shaare Zedek Medical Center, Jerusalem, Israel Michael Glikson Jesselson Integrated Heart Center, Shaare Zedek Medical Center, Jerusalem, Israel David Rosenmann Jesselson Integrated Heart Center, Shaare Zedek Medical Center, Jerusalem, Israel

Background: Left ventricular (LV) diastolic dysfunction (DD) is known to be frequent in the general population and is related to development of heart failure with preserved ejection fraction (HFpEF).

The E/e` ratio obtained from the measurement of early diastolic velocity on transmitral doppler (E) and the early diastolic velocity of mitral valve annulus obtained from tissue doppler (e`) is used as a surrogate marker of increased LV filling pressure for the evaluation of DD, associated with HFpEF. Recent guidelines determined that E/e` ratio>14 is a marker of significant DD.

The prevalence of DD among pts with CVD risk factors is not well described.

Aim: To assess the prevalence of DD as measured by E/e` ratio in a large cohort of pts with CVD risk factors referred for Echocardiography.

Methods: 5832 consecutive pts who underwent Echo-Doppler study, who had a measurement of E/e` ratio and a list of computerized diagnoses from previous hospitalization or outpatient clinic visit were included in the cohort. 315 pts with moderate/severe LV-dysfunction were excluded.

Results:

A multivariate logisitic regression model revealed that independent predictors for DD (OR; 95% CI) were: DM [2.07(1.82-2.38)]; female gender [1.82(1.59-2.08)]; age (per 10 years increase)[1.73(1.63-1.84)] and hypertension [1.52(1.3-1.77)], p-value for all <0.0001.

There was no interaction between DM and hypertension, however, a significant interaction was noted between DM and IHD, [1.43 (1.09-1.78)].

Conclusions: DD is highly prevalent among the elderly, female, diabetic and hypertensive pts which explains the increased risk of HFpEF in this population.

Mady Moriel